As you might know, sleep apnea is usually treated with PAP. In practice, PAP therapy delivers pressured air. And it does this via the mouth, nose, or both to expand the airway open while sleeping. A PAP mask must be connected to a tube, worn, and adjusted so it is comfortable for pressurized air to be effective from a PAP device.

A sleep doctor can help anyone choose a PAP machine and mask for specific needs. However, many mask combinations with configurable choices exist. Knowing many mask options exist means your chances of selecting the correct one may prove challenging.

 Coming to know the features of PAP masks and what side effects can be avoided will help you choose one.

CPAP Mask Design

Many CPAP masks are available:

·         Nasal masks

·         Pillow nose masks.

·         Masks over nose

·         Masks under and around the mouth

The most common PAP masks are nasal and oronasal. Some experts recommend starting with a nose mask and then attempting to fit with other types when the results are unsatisfactory. PAP success typically depends on choosing the right mask.

Nasal Masks

Pressurized air is delivered through nasal masks. A frame supports a flexible silicone cushion that fits around the nose, nasal bridge, and upper lip. A strap behind the head secures nasal masks.

Nasal PAP masks have various advantages over others:

·         Usually more comfy

·         Fewer air leaks

·         Extended usage

·         Less costly

Nasal masks aren’t for everyone. Nasal masks are less effective for mouth breathers. A mustache can also cause mask fit issues and air leaks.

Nasal pillows

Nasal cushions may be more comfortable than masks. Flexible silicone prongs seal each nostril to allow air into the nasal cavity. 

Some people like nasal pillows, such as:

·         Individuals with hair on the face

·         Claustrophobia sufferers

·         People interested in the smallest masks.

Nasal pillows can be as effective as conventional nose masks during PAP therapy, largely because they may not leak at greater pressures. 

Oronasal Masks or Full-Face Masks

Oronasal masks distribute air nasally and orally. They may aid nasal or nasal pillow PAP mask users with “mouth leaks”. PAP machine pressured air leaks from the mouth.

Because oronasal (full-face) masks are less comfortable, some people may take them off throughout the night or skip using them completely. 

Common PAP Mask Issues

PAP masks should be comfortable and effective. As you grow accustomed to your PAP machine, try different masks. Tell your doctor or Vendor if your mask doesn’t fit or feels uncomfortable.

1.       PAP mask users may have negative effects.

2.       For nasal mask users, positive airway pressure can dry and irritate the nose. Humidifiers can make PAP more comfortable.

3.       Congestion: PAP therapy may produce nasal congestion, making airflow difficult. Use an oronasal mask or take some drugs to fix this.

4.       Pressure sores: PAP masks can cause pressure ulcers, bruises, or friction sores when they touch bony parts of the nose, mouth, or face. Their presence indicates a major mask fitting issue that must be treated quickly. 

5.       Claustrophobia: Masks can make certain people uneasy in small spaces. These people may benefit from a nasal cushion mask. Claustrophobia sufferers may also choose to try the mask for a short time and gradually expand their use.

6.       Face marks: Most masks’ headgear causes face imprints and interferes with hairstyles. Some mask makers consider this when creating headwear.

7.       PAP pressure discomfort: Some people have trouble breathing out against the machine’s pressure. Adjusting pressure settings and other comfort measures with a doctor can fix this.  

Making Mask Adjustments

Most commercial PAP masks are small, medium, or large. Masks don’t always account for individual facial features. Additional attachments or adjustable features are generally available for masks. 

A mask that fits and seals well is essential for efficient PAP therapy. You can work with your doctor or Vendor to make tweaks to a mask that seals properly to make it more comfortable.

Finding the Best Mask

Ongoing research is investigating if age, sex, body size, and face and nose shape affect mask choice.

As you discuss your mask options with your doctor or Vendor, consider these questions:

·         Have facial hair?

·         Do you sleep largely mouth-breathing?

·         Are you an “active sleeper,” changing positions frequently at night?

·         Claustrophobic?

Optimizing PAP Therapy

Starting PAP therapy at home requires trial-and-error and inquiries. Follow these steps:

·         Adjusting your mask, attempting a size up or down, and practicing with it during the day (when there is no sleep pressure) are useful. Find a good-fitting mask, follow your doctor’s or Vendor’s instructions, and possibly talk to your health care team often to adjust.

·         There are several accessories and masks that improve sleep apnea treatment comfort and effectiveness.

·         Follow up with your doctor: Sleep apnea treatment is usually long-term. Regular checkups with your doctor are crucial. They can assist you fix mask or PAP machine difficulties and track therapy effectiveness. 

·         Actively manage your treatment: Lifestyle adjustments and medication may treat sleep apnea. Becoming better informed about your diagnosis and treatment options will enable you to choose a mask. 

·         Engage your bed partner: Bed partners can assist evaluate PAP success and identify sleep difficulties. When seeing your doctor, mention your partner’s findings regarding how often you use your PAP machine and whether it disrupts their sleep.

It is always a good idea to explore your PAP mask options.

 At OSC, when one purchases a PAP device, there is always the opportunity to try a PAP mask prior to its purchase. Testing a mask first facilitates a smarter purchase decision and the commitment to PAP therapy. Call the nearest OSC location for details on our Contact Us page on our website 

Written and edited by

Bill Bistak

Sleep Clinician

Ontario Sleep Care

Thornhill Location