CPAP Masks

Not actually Erin.

Picture by KJ Photography

& is used with permission.

You've had your sleep study done and you've selected your CPAP machine. Now on to the million-dollar question: What kind of mask should you get?

That's a question only you can answer, and it may take some experimentation to find out. I thought that because of my deviated septum and my tendency to be a mouth-breather when I sleep that a mask which covered both my mouth and my nose would be the best choice; unfortunately, it turns out that I cough a lot at night and coughing into my breathing supply is quite unpleasant. I was fortunate in that a friend of mine gave me some spare masks to try, and last night was the first time I was able to wear the mask ( a device which only covers my nose) through the entire night. 

In this post I will discuss the different types of CPAP masks and their pros and cons. 

Nasal Pillow Masks

These are minimalist masks which are much like the hoses which feed oxygen into your nose when you are receiving medical treatment, except that they have straps to ensure a snug fit while you sleep and mushroom-shaped nozzles called pillows which completely seal against your nostrils. 

Pros

• These masks are lightweight and the least invasive of the styles.
• They are the easiest to put on and take off, and can accommodate many different types of noses and faces. 
• If you are claustrophobic or cannot sleep with a lot of gear on your head or face, pick this style. 

Cons

• If you have a deviated septum you may have problems getting the air to flow up one of your nostrils before the pressure ramps up, making you feel like you are struggling for breath. 
• If you sneeze a lot at night, this is not the mask for you. 

A close-up of the pillows

Face Masks

These masks cover your mouth and all or part of your nose. They are the largest and bulkiest of the masks. 

Pros

• This is the mask for you if you have severe nasal congestion or if you cannot break yourself of the habit of mouth-breathing while you sleep. 

Cons

• The sensation of drowning (see below) that many new CPAP wearers suffer is made worse by these masks. 
• Do not wear this if you are claustrophobic or easily feel smothered. 
• Do not wear this if you are a sleep cougher. 

Nasal Masks

A compromise between nasal pillows and full face masks, these are masks which cover all of your nose and only your nose. They are more than a little silly to look at. 

Pros

• Not as bulky or as suffocating as a full face mask. 
• Not as insecure as a nasal pillow mask. 
• If you have a deviated septum, inserting one of these in your nostrils works to open your nose and allow airflow. (They did not work well with the pillows, as the snug seal against the nostril made them uncomfortable)

Cons

• Still pretty bulky. 
• Not very easy to put on or take off quickly. 
• If you have a large or misshapen nose, the mask may not fit you well (the tip of my nose frequently bumps against the part where the tube joins the mask). 

That Drowning Feeling

I'm told that it's very common for new CPAP wearers to have a feeling like they are suffocating or drowning, and that it's something you just have to get used to. I know that I had that feeling and ended up ripping off my mask after a couple hours, and it was only until I found the right mask configuration that I was finally able to sleep through the night with it. 

You may be wondering how it's possible to feel suffocated by air, but it's true. Air is a fluid, meaning that it flows and has thickness; the more pressure air is put under, the thicker it is and the more it flows like water. Think of when you put your hand outside a car window and the way the air changes when you speed up; when you accelerate you are effectively hitting the air at a faster rate, thereby compressing it. This "thickening" is what enables you to use your hand like a wing when you are at speed, and this is how aircraft can fly. 

Now imagine trying to breathe that much thicker air which, being a fluid, is behaving more like a liquid than a gas. That's what a CPAP -- Constant Positive Air Pressure -- does. Even though your brain knows it's air and that you can breathe it and everything is fine, it's very common to feel like you are drowning, panic, and take off the mask. 

It's taken me two weeks and trying several different masks to be able to sleep through the night. Don't be discouraged; find the fit which is right for you and give yourself permission to work up to it. The health benefits are worth the time and effort.