When you begin CPAP therapy, you want to start with the smallest and lightest mask possible. So masks that deliver air only through the nose are the place to start if it’s determined that will do the job.
There are masks that cover your nose, and there are even masks that simply fit under or in your nose. These types of masks work well if you wear glasses and want to read with the mask on. However, if you sleep on your side or stomach or move a lot during sleep, this type of mask may be knocked out of place.
Now, when using a nasal delivery device, you must keep your mouth closed for the therapy to work. If you breathe through your mouth at night (sleep with your mouth open) and cannot keep your mouth closed, the first thing to try is a chinstrap to hold your jaw up and keep your mouth closed.
Another option is a full-face mask that will allow you to breathe through your nose or your mouth. With a full-face mask, you won’t need a chinstrap because the seal covers both your nose and mouth. These masks are held on your face by elastic straps that you pull across your forehead and cheeks. This type of mask is the one most likely to stay in place during the night.
Different manufacturers size their masks differently, so you can be a certain size in a mask from one manufacturer and a different size in a mask from another manufacturer. But most masks are adjustable, so ask your doctor or CPAP supplier to show you how to adjust your mask to get the best fit.
How to Fit and Seal Your CPAP MaskTo get the best mask fit, adjustment, and seal, follow these steps:
- Sit on your bed and place the mask on your face with the straps hanging loose.
- Turn on the CPAP machine to full pressure.
- Lie down on your bed with your head on the pillow in your normal sleeping position.
- Beginning with the upper strap, and then following with the lower strap, slowly tighten the mask straps just until you get a good seal, being careful not to overtighten.
- If your mask has dual wall cushions, you need to “seat” or inflate the cushions in order for the mask to seal properly to your face. To “seat” the mask, gently pull it straight out and away from your face (about two inches) to let the cushions inflate, and then gently place it back down on your face. You will be able to tell by feel when it has inflated and sealed.
The way a mask fits is different for sleeping on your side or stomach than it is for sleeping on your back. So if you fit for side or stomach sleeping, you will need to readjust if you roll onto your back.
Sleeping on your side or stomach is better than sleeping on your back because of the mechanics of breathing. But sleeping on your side or stomach can put pressure on one side of your mask, which can cause an air leak. So, of course, you will want to try a bed pillow made especially for CPAP users.
What If the Mask Still Doesn’t Fit?If you are new to CPAP and have followed all the fitting instructions in your manual and still experience pain, skin irritation, or air leakage, you probably need a different style or size mask. If you have been using CPAP successfully for a while and then start experiencing these problems, your mask may be dirty or too old.
Most mask cushions begin to deteriorate after about six months of use and eventually become too soft to hold a seal. The straps lose elasticity and must be tightened more and more.
The cushions should be replaced as soon as they start to soften because air leaks reduce the effectiveness of CPAP therapy. And the straps should be replaced when they are too tight because that may cause facial sores at pressure points.