I hear horror stories all too frequently from patients that have given up on their CPAP because their mask wasn’t properly fitted by their CPAP equipment provider.

As you read through this article, hopefully you’ll begin to understand the reason a one size or style doesn’t fit all!

Here is a brief summary of the process that our staff at Alaska Sleep Clinic goes through in determining the best CPAP mask for our patients:

Considerations with Claustrophobia or side side sleeping and the best CPAP mask

Quite simply, the smaller and lighter the mask the better fit for the patient.

The smallest of these is the Nasal Pillows style mask.  Rather than a traditional nasal CPAP mask that fits around the nose, this style has two small cushions that fit right into each nostril. These can be great for individuals who have issues with being claustrophobic as it is the smallest of the masks on the market.  The nasal pillows also provide an amazing fit for individuals whom sleep on their sides.

The problems with the Nasal Pillows masks are:

• Because of the location of the fit (directly into each nare) the flow of the pressure delivered is direct and deliberate, thus making it difficult to tolerate at higher CPAP pressures such as those greater than a pressure of 12 cmH2O.
• It is important to be demonstrated on how the fit of this mask is tightened. If a patient tightens this style of mask too tight, they can awaken with a sore nose the next morning.

Nose Breather vs Mouth Breather and Anatomical Considerations for the Best CPAP Mask

Our sleep technologists look over the patient’s history prior to fitting them with a CPAP mask to identify any history of nasal obstruction, high arched or elongated soft palate, or retrognathia (a jaw that is recessed further back than it should be). If any of these are present the patient is sensitive to the fact that they may or may not be able to tolerate a traditional nasal mask but may need a full face mask.

It is important that we don’t automatically exclude a nasal mask because the full face mask comes with many issues that may contribute to poor tolerance and usage such as:

• A larger surface area making it harder to maintain a seal.
• Many times a full face mask requires a higher CPAP pressure setting which is important to consider when switching from a nasal mask to a full face mask.
• A higher humidifier setting on their machine is often required. Sometimes a patient has a higher tendency for swallowing air (aerophagia)  with the full face mask rather than the traditional nasal mask.
• And an increased risk of aspiration if one gets sick while wearing the full face mask.

CPAP Pressure, Shape of Face, and Leaks

These three components often play a prominent role in the selection of the appropriate CPAP mask for the individual. The higher the pressure, the greater the chance of a pressure leak.

A small leak can sometimes be more than an annoyance. If the leak is occurring around the eye area, the constant air blowing into the eye can cause an irritation to the eye leading to an infection of the mucosa leading to a condition known as conjunctivitis.

Other causes of a leak are the shapes of one’s face or even the over tightening of a poor fitting mask can actually lead to a mask leak (which often times is a result of a once good fitting mask that needs to be changed out…at least every 6 months).

I hope you have learned something today about a few of the important considerations when choosing an appropriate CPAP mask. There are many different variables to consider and even with the best know-how there is still some trial and error. That’s why at Alaska Sleep Clinic we offer a 30 day free CPAP mask exchange policy.

To learn more details about Alaska Sleep Clinic’s process for getting the appropriate mask fitting click below for an instructional video covering our exclusive SleepN program. Because we know CPAP compliance doesn’t just happen…Compliance by design is the difference!

Exclusive SleepN Program