The components of a CPAP system consists of 3 elements: the CPAP Machine, tubing, and the mask with headgear. The CPAP machine produces air pressure. The tubing transfers the pressurized air to the mask, and the mask provides air to the patient's mouth or nose. Mask headgear helps secure the device to the face and maintains a good seal. Since the delivered air is under pressure, it promotes a clear and open respiratory passage to the lungs, keeping the flow of oxygen unobstructed.
Patient characteristics govern the design and construction of CPAP masks for sleep apnea. The key attributes boil down into three aspects: patient positions, facial sensitivity, and breathing preferences. These elements play a critical role in selecting the best CPAP mask to meet individual needs.
CPAP patients tend to favor particular sleeping positions. Some prefer to sleep on their back while others prefer sleeping on their side. A few sleep on their stomach. Many patients switch up how they sleep night-to-night or several times during the same night. Nearly all masks support patients who sleep on their backs. Full face appliances aid patients with congestion. Nasal masks help side sleepers and patients that are touch-sensitive to their forehead or nose bridge. The best support for stomach sleepers is the nasal pillows style masks, particularly the type that routes the supply hose from the top of the patient's head. These support patients who tend to toss and turn throughout the night. They are the least intrusive and the most comfortable for patients that frequently change sleep positions.
Many CPAP patients experience sensitivity to the unit pressing down on their forehead. This constant pressure keeps them annoyed and awake throughout the night. Some experience sensitivity to the bridge of their nose. These sensitivities can interrupt a patient's CPAP therapy. Studies have shown that patients who experience these sensitivities have difficulty complying with the number of sleep hours they should be obtaining nightly. Most patients with facial sensitivities experience significant challenges with using a full face mask. Several manufacturers have designed alternative full face masks that route the support frame and the headgear away from the forehead. Other manufacturers implement soft, contouring cushions in the areas that are sensitive to touch. Many patients adapt to alternative types like the hybrid or one of the nasal masks to achieve a night of comfortable therapeutic sleep.
Most patients breathe through their nose, both awake and asleep. However, many CPAP patients breathe exclusively through their mouths during sleep. It is ineffective to force patients to use CPAP therapy nasally when they do not inhale and exhale that way. Many patients tend to switch from nose breathing to mouth breathing several times throughout the night. CPAP manufacturers design their products to accommodate these different breathing preferences. The full face mask and the hybrid mask allow patients to breathe through their mouth or nose. The hybrid mask also has the advantage of avoiding the sensitive areas of the forehead and nose bridge. For patients that breathe exclusively through their mouth, the best option is the oral mask.
Patients should be very selective in choosing a mask design to meet their sleeping needs. Medical researchers have found that compliance by CPAP patients wearing their breathing appliance is significantly low, especially when they are using the wrong mask for their needs.1 The ability to wear glasses, watch TV, or read a book is not a sleeping need. Sleep apnea occurs during sleep, not while reading or watching TV. Instead, a patient's concern should be about which type will best accommodate sleep. Achieving compliance with CPAP prescriptions is best by matching the patient's characteristics to the correct mask features.
There are five different types of sleep apnea masks for sale—nasal pillow, nasal, full face, oral, and hybrid. The differences in these products attempt to accommodate the different patient sleeping characteristics discussed earlier. Different design styles adapt to the patient's facial features, size, sleeping patterns, and breathing habits. Each characteristic targets the specific needs of the individual CPAP patient.
As shown in the continuum above, nasal-type masks are on the left, while hybrid and oral masks are on the right. In the center of the continuum are full face masks, which attempt to accommodate the needs for both nasal and mouth breathers. Nasal masks adapt best to the needs of people sensitive to their nose bridge or forehead by avoiding any contact with these areas. Nasal masks also appeal to users that toss and turn during sleep and shift to multiple sleeping positions throughout the night, as highlighted in blue on the continuum. Studies find that most people find nasal appliances more comfortable.2 Individuals with facial hair usually find nasal masks as their best option to form a seal around their nostrils. Oral and hybrid masks are best at adapting to the needs of people with congestion and who breathe through their mouths while sleeping. These two mask types also accommodate forehead and nose sensitivity, as highlighted in green on the continuum. Full face appliances help reduce dry-mouth or dry-nose symptoms3 and help patients that experience congestion or switch between nasal and mouth breathing during the night.
The Venn diagram above color codes each mask type and displays which type best meets patient sleeping characteristics. In many instances, several different kinds can meet a patient need as displayed where the bubbles intersect. For example, patients that experience sensitive forehead and nose bridge problems sleep better with nasal pillows, oral, or hybrid masks. Likewise, these patients should avoid a full face mask to limit contact with sensitive facial areas. Side sleepers and those prone to turn about while sleeping do better with nasal-type masks, as shown at the nasal pillow and nasal intersection. Mouth breathers do well with oral, hybrid, or full-face appliances. A back sleeper with now sensitivities would likely do well with a full face mask that accommodates both mouth and nasal breathing.
Below is a summary of the CPAP machine mask types and a link to specific information about individual products.
How to Select the Best CPAP Mask
The different designs employed in CPAP sleep apnea masks accommodate the needs of individual patients. One specific option will not support the needs of all patients. A review of the patient's sleeping and breathing habits compared with the characteristics of each mask should lead to choosing the best CPAP mask for their specific needs.
What Are the Best CPAP Masks for Beards
Individuals with facial hair find it difficult to maintain an adequate seal with their masks. The best mask choice for people with beards is the mask with the least facial contact. Therefore, patients with facial hair should consider a solution from the nasal masks or the nasal pillows that offer the least contact with the face.
What Are the Best CPAP Masks for Side Sleepers
People that commonly sleep on their side will likely benefit most from a nasal pillow mask. Side sleepers may need to experiment with a few mask options to get the best fit for their individual needs and sleeping patterns.
What Are the Best CPAP Masks for Mouth Breathers
Although it is always best to breathe nasally, some people who have chronic congestion and similar ailments find that they often breathe through their mouth unintentionally while sleeping. Sleep apnea masks that best accommodate mouth breathers include the oral, hybrid, and full-face CPAP masks, as shown in the yellow highlighted area of the continuum.