The Importance of Mask Comfort for CPAP Compliance

Continuous positive airway pressure (CPAP) therapy is the gold standard treatment option for people diagnosed with obstructive sleep apnea (OSA). The treatment involves a device that supplies a constant flow of air through a mask worn overnight. The air helps prevent the collapse of the upper airways while you sleep, to prevent apneas or “pauses” in breathing.

The key to this therapy is the mask — as you must feel comfortable wearing the mask, able to get a good night’s sleep. With the right mask, you are more likely to stay with your CPAP treatment, which has so many benefits.

CPAP can eliminate the symptoms of sleep apnea and allow you uninterrupted nights of sleep once more, but it is not a cure. Therefore, the treatment needs to be adhered to every night.

As OSA can increase your risk of serious health issues, sticking to the treatment course is crucial, and having a comfortable, properly fitting mask will boost the chances of compliance.

Finding a Mask That Works for You

The type of mask people wear can go a long way to ensuring compliance, as this study explains. It is important to work with your doctor or Sleep Care Specialist to find the style which will most likely see you persevere with your treatment plan. There are three main options:

  • Full face masks cover both the nose and mouth, and can be a good option for those who breathe through their mouth at night. They can also help those who experience nasal congestion and find breathing through the nose difficult when sleeping.  A special combination mask utilizes both an under the nose and mouth cushion to allow patients unobstructed sight and a comfortable full face option. There are 2 styles to choose from – the ResMed Airfit F30i and the Philips Dreamwear Full Face Mask.
  • Nasal Masks cover just the nose and can be useful for people who often move around as they sleep, or have been prescribed a high pressure setting to treat their sleep apnea.
  • Nasal pillow masks are positioned so they rest just beneath the nostrils and is the least invasive of the masks. This can help people who struggle with claustrophobia, as well as make it easier to read or watch TV when worn. People with facial hair may also find these masks more comfortable.

The straps on the masks will often need to be adjusted to ensure maximum comfort. Your doctor or Sleep Care Specialist can help ensure the straps are just right and are neither too loose nor too tight.

Adjusting To Masks

Masks worn overnight can require getting used to, particularly if you suffer from claustrophobia. It is best to try to adjust to them during the day before wearing them every night. To do this you can try the following:

  • Simply holding it to your face at first to get a basic feel
  • Wearing while performing daytime activities like reading, or even cooking
  • Wearing while watching TV, starting with the device on a low-pressure setting, before gradually increasing the pressure
  • Wearing during daytime naps

Eventually, the aim is for wearing masks overnight to become an accepted part of your night-time routine. However, if you are still struggling to adapt to them and remain anxious about your treatment, then you could try relaxation exercises or discuss further options with your doctor.

Struggling to Fall Asleep

Another element that can feel uncomfortable is the pressure of the air supplied by the treatment device. This can make it harder to fall asleep for some users. To counter this issue, you could use the ‘ramp’ property on the device. This allows you to set the air pressure at a lower setting to begin with, which will then gradually increase to your prescribed pressure setting. By the time it reaches your prescribed pressure setting you should be asleep.

If your device is set to Auto CPAP mode, then the device will react to any abnormal events by increasing the supplied pressure until normal breathing resumes.  These devices are found to be more comfortable because during 20% of the night we are in REM sleep where the pressure needs to be increased as the body becomes atonic.  Then during Non-REM sleep a lower pressure is required to combat abnormal events.  Patients are often asleep during these pressure changes and do not wake up as the device picks the correct setting throughout the night.

If you continue to struggle with the pressure, then your doctor may recommend an Auto BiPAP machine. This device reduces the air pressure when you exhale, making it easier to breathe for those who find the pressure of CPAP difficult to handle.

Are You Allergic to Masks?

Today’s CPAP masks are mostly made from silicone. However, previously they were made from latex which could irritate the skin, causing discomfort. If you are worried about a possible allergic reaction, you need to discuss the issue with your doctor.

As masks are in contact with the skin throughout the night, they will also need regular cleaning. If you do not clean them as recommended by the manufacturer, this can result in the type of skin blemishes you may initially attribute to an allergic reaction. Also, poorly cleaned masks tend to leak and can make noises.

Successful treatment of obstructive sleep apnea is essential to help reduce the risk of serious health issues linked to this disorder. Masks that are comfortable and which fit correctly are a key element in continued compliance with the treatment.

Working with your sleep specialist and doctor, you can make sure you have comfortable nights of good, restorative sleep.