How to Find the Right CPAP Mask: A Comprehensive Guide

By Ashley – Certified Polysomnographic Technologist

Whether you are visiting your local CPAP supplier or shopping for CPAP masks online, finding the right mask can very challenging. New CPAP users are often overwhelmed by the wide selection of masks available – there are different mask styles and within each style you have multiple different choices to choose from. 

The most common questions I get from patients are: “What mask will be the most comfortable for me?” and “Where do I start?”

When mask shopping, you want to ensure you choose the mask style that not only fits comfortably, but also suits your breathing style and preferred sleeping position.

The video below introduces you to the different types of CPAP masks:

When shopping for a CPAP mask, it’s important to consider the following features for the most comfortable fit:

Mask Fit

Finding a mask that fits properly is crucial. A poorly fitting mask leads to air leaks that are not only loud and disruptive but also detrimental to your therapy. If you’re on an auto CPAP, air leakage can cause your machine to increase pressure which causes more leaks and noise in a vicious cycle.

On the other hand, if you are using a manual or fixed pressure CPAP machine, air leaks will result in less pressure being delivered overall, rendering your sleep apnea treatment ineffective.

Sleeping Position

Not all masks are equally comfortable when it comes to sleeping positions. Full face masks are better for back sleeping than for side sleeping because the pillow tends to get in the way when you are side sleeping. Nasal masks, on the other hand, are less bulky and therefore, great for side sleeping.

Many new masks are designed with the hose connector at the top of the head. This can be very handy if you tend to toss and turn throughout the night or if you prefer sleeping on your stomach.

Later in this guide, I’ll offer specific recommendations for each type of mask. For each mask, I’ll also specify its suitability for side sleeping, stomach sleeping, and/or back sleeping.

Lifestyle Needs

Most newer masks come with magnets for easy fastening and a flexible short tube for quick mask disconnection. These “upgraded features” make life with CPAP much easier! No more struggling with your CPAP mask in the dark if you need to go to the bathroom or grab a glass of water in the middle of the night.

I am particularly a big fan of the flexible short tube; it ensures that I can come back to bed and continue wearing my CPAP. Most times, if you remove your mask in the middle of the night, you may be too tired to place the mask back on, resulting in poor compliance and therapy outcomes. 

With several years of experience in the sleep medicine industry, I’ve complied a list of helpful questions I ask my patients to help them find the right CPAP mask.

Read on to see how to narrow down your CPAP mask selection.

1. Do I wake up with an extremely dry mouth or throat in the morning? (Y/N)
2. Do I have a deviated septum or a broken nose? (Y/N)
3. Do I wake up with a blocked or runny nose? (Y/N)
4. Do I remove my dentures when sleeping? (Y/N)

If you answered “yes” to 2 out of 4 questions, you should try a full face mask.

Full face masks can prevent mouth-breathing during sleep, which is particularly important when using a CPAP machine. When you breathe through your mouth, the machine’s pressure escapes, undermining its effectiveness. The machine is designed to deliver pressure into your airway, keeping it open to avoid any partial or total blockages responsible for obstructive sleep apnea (OSA).

The pressurized air escaping from your mouth is also highly uncomfortable, often resulting in a dry mouth and a sore throat. Over time, this can cause the following health issues:

• Increased plaque, tooth decay, and gum disease.
• Mouth sores.
• Yeast infection in your mouth (thrush).
• Sores or split skin at the corners of your mouth, or cracked lips.
• Poor nutrition from having problems with chewing and swallowing.

Did we mention that the sound of air rushing out of your mouth is also incredibly loud? Even if you are the type of person who can sleep through anything, chances are your bed partner doesn’t appreciate the noise.

Full Face CPAP Mask Recommendations

Traditional full face masks:

ResMed AirFit F20 Full Face Mask

Stomach Sleeping: No

Side Sleeping: Not ideal

Back Sleeping: Yes

Fisher & Paykel Vitera Full Face Mask

Stomach Sleeping: No

Side Sleeping: Not ideal

Back Sleeping: Yes

Fisher & Paykel Simplus Full Face Mask

Stomach Sleeping: No

Side Sleeping: Not ideal

Back Sleeping: Yes

Minimalistic Full Face Masks:

ResMed AirFit F30 Full Face Mask

Stomach Sleeping: No

Side Sleeping: Yes

Back Sleeping: Yes

ResMed AirFit F30i Full Face Mask

Stomach Sleeping: Yes

Side Sleeping: Yes

Back Sleeping: Yes

Philips Respironics Amara View Full Face Mask

Stomach Sleeping: No

Side Sleeping: Yes

Back Sleeping: Yes

Sometimes a full face mask just doesn’t work. For instance, CPAP users with facial hair often struggle to achieve an adequate seal with their full face mask. In such cases, a nasal pillow mask and chin strap combination is a good alternative.

The nasal pillow mask provides a better seal than other mask styles because it sits above the upper lip, avoiding contact with any facial hair. Unfortunately, nasal pillow masks leave the mouth free to drop open during sleep which is where the chin strap comes in. The chin strap holds your jaw closed to prevent mouth-breathing. Thus the combination of a nasal pillow mask and a chin strap achieves the same result as a full face CPAP mask.

If you answered “yes” to less than 1 question on the “Do I need full face mask” quiz above, then a nasal mask or nasal pillow mask are better options for you.

Now comes the question, “How do I choose between the two?” This really depends on comfort and what works for you.

1. Do I sleep on my stomach? (Y/N)
2. Do I feel claustrophobic easily? (Y/N)
3. Do I have a flatter nose bridge? (Y/N)

If you answered “yes” to at least 1 question, I suggest trying a nasal pillow CPAP mask.

The nasal pillow mask is the lightest and least cumbersome style of CPAP mask. Small and easy to wear, it’s the most popular style for new CPAP users. 

However, it can take some time to get used to a nasal pillow mask as the air pressure from your CPAP machine is directly administered into your nostrils. This causes nasal dryness and irritation for some people. If this happens, we suggest increasing the humidity setting (if using a humidifier) and using a heated hose as well. 

It’s also common for some nasal pillow mask users to develop some dry skin or calluses at the base of the nose/opening of the nostrils. If this occurs, rub a small amount of petroleum-free moisturizer onto the skin for some relief.

Many CPAP users like lanolin cream which is readily available in drugstores and big box stores. Lanolin is yellow fat from sheep’s wool and is safe to use on silicone mask cushions.

It can take a few weeks to break in your mask. Once you’ve adjusted to the nasal pillow mask, skin irritation shouldn’t be a problem. Remember to avoid moisturizers that are too heavy or oily. They can clog your pores, leading to skin irritation and breakouts.

Nasal Pillow CPAP Mask Recommendations

ResMed AirFit P10 Nasal Pillow Mask

Stomach Sleeping: No

Side Sleeping: Yes

Back Sleeping: Yes

ResMed AirFit P30i Nasal Pillow Mask

Stomach Sleeping: Yes

Side Sleeping: Yes

Back Sleeping: Yes

Philips Respironics DreamWear Silicone Nasal Pillow Mask (2021 version)

Stomach Sleeping: Yes

Side Sleeping: Yes

Back Sleeping: Yes

Fisher & Paykel Brevida Nasal Pillow Mask

Stomach Sleeping: No

Side Sleeping: Yes

Back Sleeping: Yes

The final style of CPAP mask left to cover is the nasal mask. Nasal masks seal around the entire nose or under the nose and are a great option for side and back sleepers. If the idea of having something plugged into your nostrils doesn’t appeal to you, a nasal mask will probably be your preferred choice. 

Nasal masks also have the added benefit of being more comfortable than nasal pillow masks on high CPAP pressures (10 cm H2O and greater). This is because the air pressure isn’t being directly delivered into your nostrils. It is also easier to exhale with a nasal mask than with a nasal pillow mask.  

Nasal CPAP Mask Recommendations

ResMed AirFit N20 Nasal Mask

Stomach Sleeping: No

Side Sleeping: Yes

Back Sleeping: Yes

Philips Respironics Wisp Nasal Mask

Stomach Sleeping: No

Side Sleeping: Yes

Back Sleeping: Yes

Philips Respironics DreamWisp Nasal Mask

Stomach Sleeping: Yes

Side Sleeping: Yes

Back Sleeping: Yes

Fisher & Paykel Eson 2 Nasal Mask

Stomach Sleeping: No

Side Sleeping: Yes

Back Sleeping: Yes

All masks can leak when we change positions in our sleep. This is virtually unavoidable but not a big deal unless the leak is so high it affects your sleep therapy.

Some steps to ensure the leak is controlled at home are by changing your mask frequently as indicated on the packaging or as instructed by our medical team. 

Most newer machines can advise a leak threshold. So, ensure that your CPAP machine is set to the correct mask type to get the correct reading on any leakage. The optimal reading for leaks should be under 24 liters per min on ResMed machines.  

Also note that most masks have an exhalation port, and you should feel some air escaping from these small ports. Some masks, such as the Fisher & Paykel Eson 2, come with a diffuser to cover the exhalation port so your bed partner does not feel the cool breeze. 

Airflow out of these ports are normal – they let CO2 escape so it’s important not to cover them up! Ensuring you have proper pillows and mattresses for your goodnight’s sleep can also play a huge factor in a comfortable sleep with your CPAP setup. 

Try setting up your new mask 30 minutes prior to bed, grab a good book, take some slow deep breaths and relax before you embark on a goodnight’s sleep. Remember that you are not just starting a new treatment for your health but also establishing a new bedtime routine. Give yourself time and be patient with yourself!

If you have any questions about CPAP masks, whether you’d like some more advice choosing a mask or have questions about a particular mask, we are here to help.

Connect with our team of experienced medical staff for personalized mask recommendations or visit our YouTube channel for more CPAP mask purchasing tips.