During the first 15 years after nasal CPAP became commercially available, there were a variety of masks but only one manufacturer of nasal pillow systems (Snugfit or Breeze). Since 2000, many other manufacturers developed nostril interfaces that improved the comfort of wearing nasal CPAP. As masks (either nasal or full face) provide coverage over the face, masks typically feel more confining. Because of the increased size, masks have a tendency to be dislodged or to shift during a night, allowing for leaks. Some masks are heavier than others. Manufacturers of masks have attempted to improve the surfaces and comfort. The key to successfully wearing a mask is to learn how to make it snug without overly tightening the straps.

If you awaken in the morning with red skin from a mask, it is likely that the mask is being worn too tightly. The best way to adjust a new mask is to lie back in bed. Get the air started to fill the mask. Adjust the forehead straps so that they gently hold the upper 1/3rd of the mask in-place (meant for stability rather than leaking). Depending upon the mask, you may have a feature for bridge support. Adjusting the bridge support controls leaks into your eyes without overly tightening the mask over the bridge of your nose. Then adjust the lower straps to control any leaking through the lower 2/3rd of the mask. Here is where you wish to find a fit that allows the mask to "float" on the face without overly tightening. To test your fit, roll to the side to check for any leaks and then to the other side. Readjust as needed.

The fitting of nasal pillows is much easier. The key is again to prevent too much pressure against the nostrils or in the nose. During the first week of use of nasal pillows, nostril tenderness can occur. We recommend using a beeswax product (Carmex or Burts) that is dabbed on the nostrils and also applied on the outer cones of the nasal pillow to provide a protective barrier. After the first week or two, any nostril redness would indicate that the straps are being worn a bit more tightly than needed. A disadvantage of the nasal pillow system is that excessive movement during the night will dislodge the pillows. Some people also experience the direct administration of air into the nostril as being more forceful than a mask, even though the pressure being delivered through pillow or mask remains exactly the same. Because of the smaller surface area, nasal pillows and their headgear often have to be replaced more frequently, somewhere around every 3-6 months.

Further information about improving comfort with CPAP can be found at our website at http://rs6.net/tn.jsp?et=1102878971388&s=730&e=001EL6NfjQxyETr2O06kLorTnP7MNO-5wOQT4jTIZwrjskmuLkFRXzyAKBDFaITlVvNffWjAgVTN9UKXRuHV95BCfTboYCGsiSn8ZVtifVE5FWgtFLz-Bz1rgp6EsxO0Obvg5ymxyXIi3o=