Choosing the Best Mask
One of the most important aspects of being successful with your CPAP is choosing the right mask. No matter what pressure settings you have, if your mask isn't comfortable your sleep won't be either. We'll discuss how you can choose a mask that will work best for you, and provide you with the most comfort while you sleep.
Mouth Open or Mouth Closed?
Do you sleep with your mouth open or mouth closed? This is a question that is sometimes better answered by the person sleeping next to you, but important because it determines which style of mask will be most efficient in treating your sleep apnea.
If you're a mouth open sleeper, then nasal masks are not for you. The full face mask will be the best mask for treating your sleep apnea. The reason behind this is, if you're wearing a nasal mask but sleep with your mouth open, a majority of the pressure your CPAP is delivering will come out of your mouth and read as a major leak on your machine. The full face mask fixes this by creating a seal around the nose and mouth so pressure will be delivered to you whether your mouth is open our closed.
There are currently two styles for the full face mask, the classic over the nose style and the newer under the nose style. The over the nose mask means that the bridge of your nose is being covered by the cushion. Examples of over the nose masks are the ResMed AirFit F20, and Fisher and Paykel Simplus mask. The under the nose is a newer design that was made to alleviate pressure on the bridge of the nose which can sometimes lead to painful skin breakdown and ulcers. As stated the cushion goes under the nose and over the mouth, but has slits where the nostrils are placed so you can still breathe from either the nose or mouth. An example of an under the nose mask is the ResMed F30.
The cushions for these masks range from small, medium, to large and it's very important you have the right one. When you wear the mask, there should be no obvious leaks occurring around the bridge of the nose, eyes, and chin area. The cushion from the masks should fit comfortably on your nose and not be overly intrusive in your line of sight. Ideally it will fit about midway on your chin, not slipping under your chin or slipping above your lip when you open your mouth. Ensure that the straps are adjusted in a way that keeps the mask secure to your face minimizing leaks, but does not feel overly tight causing redness and irritation on your skin.
If you're a nasal breather while you sleep then you have the option of going with a nasal mask. Occasionally some people can force themselves to be nasal breathers by wearing a chin strap while they sleep, so if you think you can tolerate a chin strap then a nasal mask just might be suitable for you. Nasal masks are generally smaller and less claustrophobic than full face masks, but can sometimes slip off a little easier than a full face mask would. There are many different styles of the Nasal masks, the traditional style is the ResMed N20, and Fisher and Paykel Eson 2. Nasal Pillows such as the ResMed P10 are also an increasingly popular model and have the least straps to fiddle around with, and go directly in the nostril. Newer nasal masks such as Fisher and Paykel Dream Wear, and the ResMed N30i & P30i, are designed in a way that allows you to connect your CPAP hose on the top of your head, rather than the front of the mask. The advantage of this is it allows you to have greater range of motion with more tubing length while you're sleeping so it can be very beneficial for side sleepers.
Finding the right size Cushion for your nasal mask can be the hardest part of using a nasal mask because there are different sizes for different shapes of noses. It is best to get fitted by a medical professional who can determine the best size cushion for your nose, depending on the length, width, and prominence of the bridge of your nose. For example the nasal mask should encircle your nose without putting to much pressure on the bridge or blowing air into your eyes. The nasal pillows should fit snugly into your nostrils without causing irritation to your nares, or being so loose that you feel it leaking in some areas. Making adjustments to the straps can help improve the fit of your masks, but overall it is the cushion that must be the perfect fit for your nose.
Recently ResMed has come out with a line of masks "For Her" that feature smaller straps and cushion sizes to fit the smaller features of some females. The smaller straps would truthfully be beneficial for anyone who has a smaller head size, and may make all the difference in feeling completely comfortable with your mask. Remember there are a lot of masks out there and certainly there is not one masks that works perfect for everyone. It may be a journey to find the correct mask for you but it will make all the difference in you becoming a successful CPAP user.
Perhaps the most annoying part of owning a CPAP is replacing your supplies every couple of months but it's important to do and will keep you in compliance with your therapy. A majority of masks have 3 key components that need to be replaced. The cushion, the head straps, and the frame. Depending on who you asks your mask cushion should be replaced anywhere from once a month to once every three months. Regardless of which replacement schedule you stick to, using CPAP wipes to keep your mask cushion clean and oil free will go a long way in preserving your mask cushion. Ideally wiping it down every morning will allow you to get the most use out of your mask cushion. Unfortunately even devices such as SoClean or UV light sanitizers won't clean the oil residue from your skin off of your mask cushion so manually wiping it is the best way to keep it clean.
The headstraps should be replaced every 6 months along with the frame. The headstraps tend to get stretched out over time and will become less and less effective at keeping the mask positioned properly against your face. Truthfully around the 6th month mark it's not a bad idea to buy a new mask all together and start fresh, that way you'll get your new cushion, frame, and headgear all in one go.