Experiencing side effects of an ill-fitting CPAP mask is a common reason why people discontinue CPAP therapy. Whether you've been prescribed a full-face, nasal, or nasal CPAP pillow mask, understanding how to properly put on your mask and headgear can help ensure you continue therapy, which reduces many health risks associated with obstructive sleep apnea.
A CPAP mask fit shouldn't feel too tight, but it also shouldn't feel too loose or like it could easily slip off. Air shouldn't leak once you turn on the CPAP machine, and the straps shouldn't leave red indentations on your face after sleeping. Following your owner’s manual instructions for putting on your mask can be helpful if you’re using a new mask for the first time.
We provide step-by-step instructions for putting on each type of CPAP mask, and share some tips for addressing common problems people experience with their CPAP mask and headgear.
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What Type of CPAP Mask Do You Have?
There are multiple types of CPAP masks. Having the right mask type for you will help your CPAP therapy feel more comfortable, so you'll be more likely to stick with it. Your doctor, sleep specialist, or sleep technician can help you identify which mask type might be best for you.
Nasal Mask
A nasal CPAP mask delivers air from a CPAP machine into a sleeper's nose, but not their mouth. Traditional nasal masks are rounded to create a seal from the bridge of the nose to the upper lip, covering both nostrils. These masks can comfortably fit a large percentage of people, but aren't recommended for stomach sleepers because of their bulk and “tube-down” design (hose connected at the bottom of the mask).
Like traditional nasal masks, nasal cradle masks also cover the nostrils, but they are smaller and don't reach the bridge of the nose or upper lip. Many nasal cradle masks also have a “tube-up” design with the hose connected at the top of the mask’s frame. This helps keep tubing out of the way for sleepers who toss and turn at night.
Nasal Pillow Mask
Like nasal masks, nasal pillow masks deliver air into a sleeper's nose, but not their mouth. But instead of covering both nostrils, a nasal pillow mask features two small pillows to seal the left and right nostril openings. The minimalist design of nasal pillow masks means there are fewer components to clean, and it’s less likely to interfere with wearing glasses, watching TV, or reading before bed. Nasal pillow masks come in both tube-up and tube-down designs.
Full-Face Mask
A full-face CPAP mask, called an oral-nasal or oronasal mask, delivers air to both the nose and mouth. Traditional full-face CPAP masks often have a teardrop or rounded triangle shape that extends from the bridge of the nose to below the mouth, covering both nostrils, the mouth, and part of the cheeks.
A hybrid or minimal full-face CPAP mask also seals the mouth, but doesn't cover as much of the face as traditional full-face masks. These masks usually feature a cradle to provide airflow for both nostrils without covering the rest of the nose.
How to Put on a Nasal Mask
To put on a nasal CPAP mask, follow these steps:
- Position the nasal mask or nasal cradle over the nostrils.
- Hold the nasal mask or nasal cradle in place over the nostrils with one hand, then use your other hand to pull the straps over the back of your head.
- Connect straps to the front of the mask using magnets, Velcro, or whatever fixture type is built into your mask. Some masks may require you to connect straps on both sides, while others have straps that only need to be connected on one side.
- If the mask feels too tight or too loose, adjust the straps accordingly.
How to Put on a Nasal Pillow Mask
To put on a nasal pillow CPAP mask, follow these steps:
- Position the nasal mask or nasal cradle over the nostrils.
- Hold the nasal mask or nasal cradle in place over the nostrils with one hand, then use your other hand to pull the straps over the back of your head.
- Connect straps to the front of the mask using magnets, Velcro, or whatever fixture type is built into your mask. Some masks may require you to connect straps on both sides, while others have straps that only need to be connected on one side.
- If the mask feels too tight or too loose, adjust the straps accordingly.
How to Put on a Full-Face Mask
To put on a full-face CPAP mask, follow these steps:
- Position the full-face mask over the nose and mouth.
- Hold the full-face mask in place over the nose and mouth with one hand, then use your other hand to pull the straps over the back of your head.
- Connect any loose straps to the front of the mask using magnets, Velcro, or other types of fixtures.
- Adjust the straps if the mast feels too tight or does not feel secure.
Tips for Wearing a CPAP Mask
If your CPAP mask still doesn't work well for you after you've properly put it on and adjusted it, consider these tips to troubleshoot problems and improve your comfort.
Rethink Mask Sizing
CPAP masks of all types come in different sizes. Regular air leaks, discomfort, or pain may indicate that the mask you're using isn't the best size for your facial structure. Most manufacturers offer fit kits that allow you to try different sizes on at home and identify what works best for you.
Try CPAP Mask Liners
Intended for full-face masks, CPAP mask liners are simple reusable or disposable slip covers that add cushioning and can help reduce irritation or discomfort where your mask touches your skin.
Pull Your Hair Back
If you have long hair, CPAP mask manufacturers recommend pulling your hair back through your CPAP headgear straps, so it doesn't interfere with the mask fit or cause discomfort. Putting your hair into a ponytail before feeding it through headgear straps may also help.
Try a Different Mask Type
If one CPAP mask type isn't a good fit for you, even after making adjustments, trying a different type or brand of mask may help. Schedule an appointment with your doctor to discuss why your current mask isn't working, and explore the other mask options available to you.
Consider Heated CPAP Tubing
Poor mask fit is often blamed for CPAP side effects like dry mouth, but sometimes another culprit is at play. If your CPAP tubing isn't heated, consider asking your doctor about adding heated humidification to your treatment to reduce dry mouth.
Ask About Air Pressure Settings
Feelings of claustrophobia during CPAP therapy are often chalked up to mask size, but they may also stem from air pressure settings. Ask your doctor if your CPAP machine has been programmed to use the ramp feature, which gradually increases air pressure when the machine is turned on, so the air doesn't feel overwhelming at first.
Still have questions?
Sleep apnea products can be confusing. If you need individualized assistance, post your question to the Sleep Doctor forum.
Written by
Jay Vera Summer, Contributing WriterJay Vera Summer is a writer, editor, and wellness coach. She holds a Bachelor's of Science in psychology and Master's degrees in both writing and public policy. As a wellness coach, she's certified by the Mayo Clinic and the National Board for Health and Wellness Coaching (NBHWC). She's been writing about sleep and other health topics for six years. Previously, she taught undergraduate writing courses for five years at the University of South Florida.
