*Please note that the masks pictured and named above are only a small selection of masks available. Resmed, Fisher & Paykel, and Devilbiss are also reputable manufacturers of masks, along with many others. However, at this time, bearing in mind we are not a huge company, we only stock Respironics’ and Devilbiss’ Hybrid masks, which is why we know their products inside out!
Well, you’ve been diagnosed with Sleep Apnoea and now the challenge begins…. Some people are very lucky, in that they are provided with a CPAP mask, pop it on, switch on their CPAP and off they go, into a place of safe peaceful sleep. Dream on….. as unfortunately for the vast majority of people this is not the case!! My own husband would tell you about the days in my own early treatment when in the middle of the night, masks would suddenly go flying across the bedroom in my frustration, and let me tell you, the air was blue and by nature I’m not prone to bad language normally! There’s nothing worse than feeling severely sleep deprived and waking up to the mask leaking or by painful skin sores etc., let alone struggling with the new experience of having to try to sleep with a mask on, accompanied by what at first feels like a gale-force wind blasting in our throats. (For anyone reading this who hasn’t tried CPAP, a good example would be to open the car window very slightly, whilst travelling at a fair speed, and take in the air coming through the window). The good news though is that after a short time you do get used to this feeling – so much so that people often think there’s no pressure blowing and pull the mask away from their face, only to discover that everything is working correctly. The important thing to remember is that whilst all of us, given the choice, would prefer not to wear a mask in bed, CPAP is still the gold standard for successful sleep apnoea therapy, and not only can you ‘feel’ much better and refreshed in yourself, but CPAP is protecting us from other serious health issues.
Myth No 1
“You should always use the same brand of CPAP mask as your CPAP machine.”
NOT TRUE:- Contrary to what some of the manufacturers tell people, practically ALL masks can be used with ALL machines, regardless of which brand of CPAP machine you have and whether it’s CPAP, Bi-PAP, APAP etc. It is hard enough to find the ‘right’ mask, without being told we have to stick to one manufacturer. Example, for me personally, my favourite mask is made by Respironics and my 2nd favourite by Innomed. Other people will differ, as to which mask suits their face and is comfortable. This is far more important than who their favourite manufacturer is! (In an ideal world, the sleep clinics would stock masks from all the manufacturers, to give everyone a fair chance of finding the one which is right for them).
Myth No 2
“To purchase a CPAP mask you need a prescription.”
NOT TRUE (except in the US):- You DO NOT need a prescription to buy a CPAP mask unless you are in the United States. In the last year or so the FDA changed the rules to include the CPAP masks and humidifiers as ‘prescription-only’ items. CPAP machines do need prescriptions though worldwide I believe. For our American ‘CPAP-User Friends,’ it is still possible to get a mask by purchasing the replacement parts as separate items, but this would prove more costly. For the rest of us, we are free to purchase our own masks, and this is in actual fact a good idea if funds allow, so that you always have a spare one on hand for emergencies!
New to CPAP
So you’ve been told you need to wear a mask for all sleeps in future, which is in itself a shock, but you should then think about your normal bedtime routine, as for a while bedtime will be very different until you are used to using CPAP. The last thing you want is to be given a mask that prevents you from reading, if that’s what you like to do before sleeping – same goes for if you’re in the habit of watching tv in bed. There are now plenty of masks on the market that allow people to wear their reading glasses, so make sure you point out these things to your sleep medic. It is very advisable, in order to begin successful CPAP therapy, that you try to keep as close to your normal routine as you can. If you have a sleeping partner, you also need to keep the love going between you. So often a person who has just been diagnosed with sleep apnoea and told they have to wear a mask for bed will feel different about themselves – possibly alienated too, so keep the intimacy there. (My own husband used to get cross with me when I would turn my back on him so he couldn’t see me with the mask on. Like he said, he’d rather have me with a mask on alive, than lose me earlier to a death caused by untreated sleep apnoea).
The next most important question you need to ask yourself (or your bed partner) is whether you breathe through your mouth, nose or both. So many people are given nasal masks first as it wasn’t confirmed how they breathe when they sleep. This is destined for the first disaster as air will leak from your mouth if you are a nose breather, and this is very unpleasant, along with the fact that all your apnoeas will not be treated! Nose breathers can use nasal masks like the Respironics’ Wisp GoLife, ComfortGel Blue, EasyLife, TrueBlue, ComfortClassic or Profile Lite (so much choice!). However, if you are a mouth breather, then you will need masks like the Amara, FitLife, ComfortGel Blue Full, Hybrid or ComfortFull 2. If you really don’t feel like you can tolerate a full face mask and you know you are a mouth breather, then you can use a nasal mask, but will definitely need a separate Chin Strap to keep your mouth from opening.
The nasal pillow masks, like the GoLife and Hybrid, are very good masks for people who prefer not to have a lot of contact on their face, but people new to CPAP often find these difficult to use at first. However, once the CPAP pressure is tolerated and has become a way of life, they are highly recommended by existing users, and especially for those would like to wear their reading glasses in bed! Do also bear in mind that if you suffer from anything like nasal congestion, you may find the nasal pillows masks hard to use. (I certainly did before my surgery to clear my nasal airways).
Other factors to take into account are:-
Do you have facial hair (beards and moustaches)? Again, the last thing you want to be told is to shave it off because of the mask, but it does tend to limit the choices of masks, as the mask seals do have a harder time sealing when in contact with hair and whiskers.
Do you use nightcream? Unfortunately, as well as preventing the mask from sealing well, most face creams contain petroleum-based substances and will damage the masks. This is why we now sell the CPAP Moisture Therapy Cream, as this contains nothing that will damage them, and the added benefit is it’s designed to treat any mask sores. It can also be used inside the nostrils for people using the Nasal Cushion-type of masks. The FitLife Mask is also good for this, as your normal nightcream can still be used (apart from the outer perimeter where the mask seals), as there is no contact to the vast majority of the skin. You also need to avoid washing your face before bed with any products containing moisturisers or alcohol, as these can cause mask leaks, as well as damaging the masks.
Do you suffer from claustrophobia? Anyone suffering from this is likely to worry even more when told they have to wear a mask on their face. The first thing to tell yourself is that “although I won’t like wearing a mask, my feeling of claustrophobia might not be too bad after all, as this mask is actually going to help with keeping my airways open and keep me breathing.” A lot of people liken it to the old days in the dentist’s chair, when the dreaded rubber mask was plonked on our face to put us to sleep to stop the pain. Well, keep in mind that this mask is a bonus, as it’s going to keep your airways open, so that your precious lungs can take in air which they crave. As someone new to CPAP, it’s always a good idea to practise wearing the mask during the day without it being attached to the machine, and then to progress to wearing it with the machine – perhaps whilst watching the television. There’s a good video on the forum to help with this here Solution For CPAP Claustrophobia. Do mention that you suffer from claustrophobia to your sleep medic, so they can try you with a mask with less contact on the face, like the GoLife or Wisp for nasal breathers or the Hybrid for mouth breathers.
For those new to CPAP, there is also a recently released book called CPAP & Ventilator Secrets with lots of tips and help. Even long-term users will probably find items of interest.
FACIAL HAIR – As mentioned above, this can sometimes cause problems if the mask cannot seal with the skin. There are several masks which are helpful:-
- Nasal Pillows Masks like the Respironics’ GoLife for Men, Resmed’s Swift FX or Fisher & Paykel’s Opus 360. These work well because the pillows are inserted into the nostrils which avoids the issue of trying to create a seal on the skin, like is necessary with other types of masks. However, it is advisable to have another mask to use alongside these as there have been reports of continuous use actually changing the shape of the nostrils. It is important to bear in mind that if you are a mouth breather you will also need a CPAP Chin Strap.
- Respironics have several good traditional Nasal Masks which appear to work better for facial hair. These are the Wisp, ComfortGel Blue, the new TrueBlue (which has been particularly designed for a looser fit), the EasyLife and also the Profile Lite (which is boiled + moulded for a more personalised fit). Other manufacturers no doubt do some masks to help this, and I have heard Resmed’s Mirage SoftGel works well for facial hair, along with Fisher & Paykel’s Zest and Flexifit HC407. Again, bear in mind if you’re a mouth breather you will need a CPAP Chin Strap.
- Finally for mouth breathers, there are the traditional Full Face Masks such as the Respironics’ Amara ComfortGel Blue Full and we have also had good reports from customers with the FitLife XL. (The reason I quote the XL particularly is that this mask was recently updated and appears to fit better in width to avoid hair at the sides of the face, and some men find they can actually wear the mask under the chin to tuck in their beards. It’s my observation that most men actually need the new XL size, and men who tried in the past with the size L are having much better success with the mask now). The Fisher & Paykel Flexifit HC432 and Forma also have good reviews for facial hair.
Whilst shaving off facial hair can be avoided with the correct mask, it is always advisable to keep the hair as trimmed as possible.
READING IN BED – I, for one, cannot sleep until I’ve gone through my usual routine of reading, and this was my first shock after putting on the mask and realising there was no place for my glasses. Back then (being a full face mask user) there was very limited choice of a mask which allowed me to also wear my reading glasses – added to the fact that I was still wading through all the different masks trying to find just one mask that was right for me! At first I used to read before putting the mask on, but that didn’t work as I would regularly fall asleep with the book in my hand. I got myself a large magnifying glass so I could read with the mask on, but I quickly developed arm ache from holding the book in one hand and the magnifying glass in the other. What a revelation it was when I discovered the Amazon Kindle, and I can now happily read to my heart’s content, even with my large FitLife Mask on. All I have to do is download my book to the Kindle and there’s a facility on them to make the fonts look bigger. Here’s an example of the largest font and you can see there are other options for smaller ones.
This isn’t the time to tell you all the other benefits I’ve found (like being able to store up to 3,500 books etc) but you can read more on their site by clicking on the following Amazon link, and there are different Kindles to choose from (in fact they now have the Kindle Paperwhite with a built-in light so you don’t nee to disturb your bed partner with the bedside lamp). I have the 3G version, so I can download a new book direct from anywhere (on the bus or on the beach etc).
There are masks available nowadays which do allow you to wear glasses, but there are definitely more choices for nasal masks than full face ones:-
- For Nasal Breathers, there are several nasal pillows-type masks like the Respironics’ GoLife, Resmed Swift series, Innomed Bravo, Fisher & Paykel Opus etc. Obviously these can be used for Mouth Breathers, but with an additional Chin Strap.
- There are 2 options I know of for nasal pillow-type masks for Mouth Breathers, which are the Devilbiss Hybrid and the Resmed Mirage Liberty, as these both have separate mouth pieces.
- Again for Nasal Breathers or Mouth Breathers with an additional Chin Strap are the Respironics’ Wisp , Resmed Mirage FX or the SleepWeaver.
- For Mouth Breathers there’s the Resmed Mirage Quattro FX.
- Finally, there is an interesting mask with no headgear or straps. I have absolutely no experience whatsoever on this one, but it might be worth a look, and I’d be interested to hear any feedback on it via the Contact Us Link.
CHILDREN – Getting a mask for a child is quite challenging, and with very young children or those who can’t speak for themselves, it’s obviously difficult to know just how comfortable the mask is. There are several Nasal Masks specifically designed for children, like the Respironics’ Small Child Profile Lite which comes with a Mesh SoftCap to help keep the mask in place. Resmed do the Mirage Kidsta Mask and the Pixi, Innomed have the Nasal Aire II and SleepNet the MiniMe Petite. The availability of Full Face Masks is very limited, but the Respironics’ FitLife in the size small is proving to be very helpful – especially for young tender skin, as the mask seals around the edge of the face, thus avoiding the more delicate areas. A lot of children also find the adult Nasal Masks serve well as a Full Face Masks on children.
One of my customers has kindly given permission for other parents to see some pictures of her own young son, Emil, wearing his FitLife Mask which their hospital provides and which has solved their problems, in the hope that other parents can see it and perhaps request them from their hospital if they think this is the answer for their child. You can view the images by clicking on this link…. Emil Wearing His FitLife Mask
Another problem for children can be the headgear being too big or slipping, but there is a helpful solution which works for a lot of people by using the SoftCap Headgear, which comes in both Mesh and Lycra versions.
Parents and Carers of children need to keep checking that the current mask size is suitable, as so often we tend not to notice our children growing before our eyes!
STOMACH SLEEPERS – There’s an important warning for people who sleep on their stomach, in that they must be very careful that they do not block the exhalation vent on the mask. This can cause a harmful build-up of carbon dioxide! Side sleeping is recommended as the best position to sleep in for people with obstructive sleep apnoea. However, for those who have to sleep on their stomachs, there are several masks people do gain success with in this sleeping position:-
- Nasal Pillows Masks, such as the Respironics’ GoLife, Resmed Swift, Fisher & Paykel Pilairo and Fisher & Paykel Opus.
- ‘Traditional’ Nasal Masks – Respironics’ Comfort Gel Blue or Easy Life are good options, as both are very soft on the face. My guess is that both the Wisp and TrueBlue may also be a good ones but at the moment I have no statistics on this for stomach sleepers yet. Resmed’s Mirage Vista and Mirage Micro are also good options – as are Fisher & Paykel’s Flexifit 405/406 and the Zest.
- For Full Face Mask users there is the Amara, Respironics’ Comfort Gel Blue Full or the Resmed Mirage Quattro FX.
Do bear in mind that once you have found a suitable mask, there are often minor issues still to overcome, like strap marks, nasal bridge sores and hose comfort etc., and for this there are lots of comfort products available – most of which are available on our website at Hope2Sleep. Another option when struggling with the masks headgear are the Soft Caps, for which there are 2 options – Lycra Soft Cap and Mesh Soft Cap (I use the Lycra one myself with the FitLife).
Cleaning the masks daily, is very important to ensure a good mask seal, as well as lengthening the life of them, as they are not cheap to replace. I will write a future blog on cleaning the equipment, but for now I will tell you that I personally use the CPAP Mask Wipes everyday without fail. Not only do I have very little issues with my mask not sealing, but I also get a long life out of my mask before needing to replace it. This is important to me, as my own clinic is not able to supply my FitLife. They do, however, give me my 2nd choice of mask every year, so I’m not complaining! I’m a big believer in using 2 different types of masks, as long-term use of the same type can alter the structure of our faces due to the same pressure being applied in the same areas.
Warning: Do not use any other types of cleaning wipes on your masks containing alcohol, as this will damage them.
I do hope this Blog has helped, and please feel free to contact us direct for any further advice, especially regarding the Respironics’ Masks, as I have personally trialled every single one of them myself. Masks are expensive, and I hate to hear of people making my past mistakes by ordering them, only to find they are not suitable (I have a cupboard full of masks I’ve wasted my money on). However, you just cannot put a price on the benefits of good sleep, and the ‘right mask for you’ is worth it’s weight in gold!
I will update this Blog as new masks become available, so it might be a good idea to save this to your bookmarks or favourites to refer to in the future. Also, don’t forget to ‘Sign Up For New Blog Posts’ on the right-hand side if you haven’t already.
Best Wishes for Safe Comfortable Sleep!