Which CPAP Mask is Best for Me?

With dozens of CPAP masks available, which one is right for me? All of the mask types are explained in this article and I give you tips on choosing the best option for you.

Mask Types

Traditional Nasal Masks

Nasal masks are the most common interfaces used by patients and are typically triangular in shape and cover the nose. Most have additional forehead braces with pads that lay above the eyebrow area to add stability. This mask works best for patients who sleep with their mouths closed and are able to inhale and exhale well through their nostrils only.

Components include a hard plastic like frame which holds a softer inner cushion that lies against the face. Head gear consists of the straps and sometimes a forehead brace.

Nasal Pillow Masks

Nasal pillow masks have gained great popularity in past years. They work best for patients who sleep with their mouths closed and are able to inhale and exhale well through their nostrils only. They are a better choice for patients who have a narrow nose bridge or short face and have difficulty with Nasal Mask fit and leak in to the eye area. Since nothing lays above the nostrils, nasal pillow masks work well for patients who may otherwise be intimidated by the size of traditional nasal masks or have claustrophobia issues.

Components include a frame which holds the soft nasal pillow cushions which attach to strapped head gear.

Full Face Masks

Full face masks cover both the nose and the mouth. They are prescribed for patients who are mouth breathers.

Components include a hard plastic like frame which holds a softer inner cushion that lies against the face. Head gear consists of the straps and sometimes a forehead brace.

About Mask Sizing

There is no industry standard for mask sizing and so brand to brand and even within manufacturers, sizing can greatly vary. It is vital that we try on masks to know what size we need. Sizing choices can be found to include petite, extra small, small, medium, large and extra large. Many masks today come with a variety of mask cushion sizes within the packaging which takes the guess work out of the decision making process. Most masks include the strapped headgear which comes in “one size fits most” however smaller and sometimes larger sizes are available upon request or special order to accommodate those patients with a small or large head circumference.

Size Up Your Face

Most manufacturers offer sizing gauges for each of their mask products. These are useful as a starting point in determining mask size but not always completely accurate due to other variables with each of our individual facial features.

Facial features to consider when choosing a mask are: length of the nose from nose bridge to base, width of nose base, width of nose bridge; surface area of upper lip (the skin between the base of your nose and your top lip), distance between eyes and overall circumference of the head.

Consider that nasal masks and nasal pillow masks rest on the upper lip so pay particular attention to this area of the face when trying on masks. The base of the frame should not touch the top lip.

Mask Fit and Adjustment

After you have chosen the best mask size and style for your face, you must adjust it properly before sleep. Sit on your bed, turn machine on, and place mask on your face with straps loose. Lay down in your sleeping position with your head on your pillow as you would normally sleep. Slowly pull the straps JUST UNTIL you get a good seal.

Seating a Dual Cushion Mask

If your mask has a dual cushion, it will need to be “seated”. After you have fitted and adjusted your mask using the steps above, to “seat” gently pull the mask straight out and away from your face to allow the dual cushions to inflate properly. Lay the mask gently back on your face.

Don’t Expect Perfection

If you shop wisely, and try on a variety of masks, you should be able to find the best possible mask choice for your face. Know that all masks can and do leak, but usually, this occurs when we change positions during sleep and that just cannot be helped. We have little control over what we do in our sleep! Your CPAP and mask provider can help you in your search for the best mask choice, but you need to take responsibility to keep them informed as to what works and what does not. Ask your supplier about 30 day mask exchange programs that allow the patient to try a mask at home for up to 30 days with the option to exchange for another mask in the event it does not work well.

It took me 18 months to find a mask I could tolerate for the entire night. I settled on the ResMed P10 (nose pillows). I’m getting better sleep but now I need to address insomnia to sleep more than 4 - 5 hours per night.

Paul, that’s interesting. I have taking to rotating masks, almost like “what do I want to wear today?” I have validated they all work so now it is a personal preference. Sometimes I just get tired of the same old thing.

1 Like

I am new to the CPAP and wondering about the best mask type since I wear a beard
Appreciate any guidance

For beard like the Resmed Swift FX. It does not touch the face. http://www.resmed.com/int/products/swift_fx/swift-fx.html?nc=patients

Another is a mouth guard/mask combo. It frees the users form having straps that touch the face. tapintosleep.com/breathing-devices/patient/tap-pap/

Many men with beards appreciate using nasal pillows because of the small size of this mask. ResMed Mirage Liberty provides full face mask with nasal pillows should you be a mouth breather.

For now, I’m sticking with what is working until I get to the bottom of my insomnia…

I miss my old map that vented out the top. The one I’ve been given for the past year or so vents near the mouth area, which is annoying for me because I sleep on my stomach and/or side and have long gotten used to holding the mask with one hand. Suddenly I had a mask that caused problems because where I was used to holding it was where it vented, and I was suddenly covering up the vent.

Miss the old mask :(.

Is the old mask obsolete and not available any more? What brand/style was it?
Golly, when you have something that works, it’s a shame to have to give it up!

I see patients almost everyday with full beard and they’re able to use ANY type of mask especially with what’s available in the market today. Most of these patients understand why they need to use their CPAP, and that alone is enough for them to accommodate any masks even if they have to do lots of adjustments to minimize air leaks.

Nasal masks (any type that delivers air to your nose only) are smaller, lighter, easier to adjust if there are any air leaks, and easier to tolerate. BUT you have to do your best to consistently close your mouth in order for you to get the full benefit of the therapy. Sometimes it’s hard to do that especially if you are a new user and on a higher pressure setting (anything over 10-12 CWP). I’ve seen pro users on pressures of 20 (or more!) using nasal masks and have little issues.
Full face masks (any type that delivers air to both nose and mouth) are of course a little bigger, have more surface area that it needs to cover. Therefore expect to deal more air leaks that needs adjusting, especially if you have a beard. BUT if you end up opening your mouth it doesn’t matter. You will get the full benefit of the therapy.

Hope this helps you to at least decide what type of mask you should use. No need to shave for sure. :stuck_out_tongue_winking_eye:

I’m at Kaiser, and so have to go with the masks they’ve got to offer. It is annoying.

I can understand insomnia; The masks themselves can cause it. The manufacturers engineering design personnel should have to wear his design for a full month. Comfort is not an option, if Seepweaver and ResMed would combine their best features, we could have a descent full, or other mask.

Our faces are unique and finding the best mask for our individual faces can be challenging for sure.
I eventually went with nasal pillows because it is less on the face. I was challenged with a short face and narrow upper lip. Air leaking in the eye area was always one of my biggest challenges with fit and adjustment.

I’ve used nasal pillows for 25 years now and while not perfect ( no mask is perfect) it continues to work for me. I just started using ResMed AirFit P10 nasal pillows and they are light as air, easy to use and they don’t move as I change sleeping positions during the night.

I think there IS a great mask out there for each of us. Sometimes you just have to do the try it til you find it thing. Just don’t give up.

I have used many many masks. I struggle with all of them. I am now on a BiPAP machine. I can not get any sleep. I’m looking for surgical procedures that may work for people.

Hi Red;
So can you tell us what your bilevel/mask challenges are? I struggled for a year before I found myself looking at trach or death. It was a really caring second opinion doctor and his staff who finally provided and helped me make bilevel work. It was learning all of the comfort features available on the machine, having the right bilevel settings, knowing how to use the humidifier properly and then mask…darn it, I had been handed a size medium mask, when I needed a small. For a year I had bruised cheek bones and cut nose bridge from having to pull the straps tight so the mask would not leak. (sigh) Finally a kind CPAP provider spent time with me and introduced me to not only mask choices in the right size, but education on how to adjust the mask for sleep. It saved my life. No one had taken the time to educate me.

Surgery…I had the UPPP - which actually worsened my apnea. Took me from CPAP at 9 to BiLevel at 20-11 in a matter of a few short years.
So, surgery, what I can share with you is that you must know WHY you have apnea in the first place…what are your anatomical features that block your airway…airway size, abnormal tonsils/adenoids, uvula, tongue, jaw etc. Only when you know WHAT causes you to stop breathing can you begin to think about what surgical options are available to you.

I got may hands on the surgical notes 10 years after I had the UPPP - in the doctors notes it said I had a normal size airway, yet he enlarged it, I had a normal size uvula, yet he removed it, I did not have an abnormal palate, yet they trimmed it. Scar tissue grew at each point touched by the laser…worsening my apnea.

I am not saying there may not be a surgical solution for you, just sharing my story to give you food for thought. When something is removed, it does not grow back!

Has any doctor explained WHY you have sleep apnea? Has any doctor recommended surgery?

I feel for you, still well remember the struggle and desperation for healthy sleep.

Thank you for sharing that information. I have never been informed why did had the sleep apnea. I’ve never been informed about the anatomical structure of my job. I will kid with that ASAP. I know it use a I had a bi level of machine had a CPAP machine at 14 with my level and then they put me on bipap and I got a mask that covered my nose and mouth. The tubing drives me insane. I wish I could just use nasal pillows with no mask. Have high blood pressure. I have chronic back problems in chronic pain. I’m a former professional athlete and I can’t even walk 15 yards without taking a knee. Hypothyroidism. Manic depression anger issues the list goes on and on.

This, easily, is one of the most concerning components of a new sleep apnea diagnosis. I have not seen studies but have to believe that improper utilization of a mask due to discomfort, downright pain (my first mask caused excoriated skin on the bridge of my nose), poor fitting, dry mouth, etc., has to be high on the reasons for discontinuing this therapy.

So, yes, this is a super important topic. But, all should know that being told what “the best mask” for one individual, may be unpleasant for another. This happens with frequency as each of us are unique in every way! One part being we have diverse facial components with a wide variation of the positions, shapes, and sizes of our nose, mouth, lips, teeth, nares, etc.

Therefore, finding the ‘right mask’ is a very personal decision that may require some trial and error. Personally, I must have tried a dozen or more masks but, then again, I prioritized moving from a full face-mask to to nasal pillows. Sleep well all!

Millions of people suffer from insomnia and sleep issues. Some people have to work the graveyard shift from (11:00-7:00) and have to deal with sleeping during the day. Humans are not nocturnal and sleeping during the day or having insomnia can be frustrating if you are unable to get the sleep you need.Light may be a part of your issue if you have trouble falling asleep especially in the summer months when the days are longer. If you are one of the millions who have to deal with sleep issues, a simple sleep mask may provide a solution.Most people do not even consider a sleep mask because of the way it looks… The macho guy or gal who thinks wearing a sleep mask looks stupid, is putting their own health at risk. Many people who get a minimal amount of sleep tend to be more stressed and less healthy because their bodies are unable to rest appropriately.
i suggest you to buy now your own 3d Sleep Mask from Amazon

You have a lot of company, as long as these manufacturers have a dusty stock of old first generation masks on their shelves, the problem will remain; They will not use the technology available to design, and manufacture a comfortable mask.