Deciding which mask to use can be very difficult. There is such a great number of tools and information available to you; you can also ask your healthcare professional for help. Before being influenced by a healthcare professional however, do some research! Look into reviews of different mask and the advice offered. It may mean the difference between an amazing night and your sleep forever improving your health compared to not tolerating and struggling mightily. You may sway from a tradition nasal style of mask to a more specific style of nasal hybrid. Also remember that nearly every manufacturer allows for a mask exchange policy that your DME provider can utilized; meaning that if you use a new mask, but do not tolerate well and need to switch it can be done at no charge to you through your DME provider. You have a safety! So review, research, question and decide!
After you have decided to use a nasal style of mask, now it is time to choose which one you want to use. This can be a difficult task when you start adding in the factors. My suggestion is that first you look in a mirror! Look at your face shape and shape of your nose, even if it is seems weird! Take into account the length, height, curve, depth of bridge and so on! When you are trying on a pair of shoes you take many things into account. Do the same with your CPAP mask. remember that each mask will offer some sort of strength to your face shape and weakness. Weigh what would work in strength versus that weakness. There are many professionals willing to aid you with a vast amount of information available via the internet. Just remember, each mask does not fit the same on every single person! You can even measure the features of your face if needed.
After you have studied your face shape and what you feel a problem area could be a next essential step is to truly evaluate if you are a mouth breather or not. Now given, some people naturally open their mouths when sleeping with CPAP therapy regardless, but for a new patient this is simply not certain! So, do you mouth breath? Not only when sleeping, but when you are awake. How severe do you feel it is? Do you feel you may have the jaw muscles and fortitude to keep your mouth closed nightly? Sometimes it is simple for a patient and sometimes more difficult for others. Search yourself and find if you are comfortable with overcoming this issue. Sometimes, in cases of uncertainty, then just try a nasal style. If it doesn't work and a chin strap or full face mask is needed then at least you have tried the smaller styles of mask and acclimation will be easier to a full face CPAP mask. Remember, there is nothing wrong with a full face style of mask! In fact, many patients prefer the full face mask due to the comfort it gives them! One factor that can be overshadowed is nasal congestion/allergies. Some patient's love to use a nasal mask until congestion/allergies become an issue, then utilize a full face mask for the time being. There are some amazing full face masks available for patient's on the market, along with some amazing nasal styles as well!
I want to focus on helping new users specifically, but seasoned users may fine helpful information! I also want to clarify that I want to focus on the "traditional nasal CPAP mask". This means not the "hybrid" style of nasal style of mask.
The first step of any good fitting nasal style of CPAP mask is the correct fit. Most masks come with a fit guide to help you find the correct size of the mask measuring both the height and width of the nose. Some of these fit guides can be more concerned about the width rather to height and some are more concerned with the height as to width. By finding that correct size can alleviate a great deal of problems for most patients as wearing an over-sized or under-sized cushion can lead to severe problems! Here is the warning when finding the right nasal style for you in relation to the size of the mask. First - the mask you have chosen may require that you fit a larger/smaller size than originally fitted. By fitting with the fit diagram provided from the manufacturer can assure that you have seen what is simply suggested, but may be maneuvered. After all, when you are trying on a new set of shoes you typically understand the size you usually prefer, but that it may not be the correct sizing in that brand/model. Finding the right size for you will help assure your comfort and avoid other problems from quickly arising.
By choosing this style it is important to note the potential dangers and problems that can arise. By doing so you may
be able to properly choose which type of nasal mask or the sizing in a better way! The first big danger is something known as "decubitus". In more common terms, this is a pressure sore and can become the Achilles heel of the nasal style when the incorrect mask is fitted or the incorrect sizing used. A pressure sore can occur in many ways on any portion of the skin where the mask is pressing to tightly throughout the night. If you have had a pressure sore before, you know the dangers are high and the pain can be pretty severe. It can ruin your CPAP therapy experience even leaving a scar. Sometimes a mask must be tightened for a proper seal, but try to find a mask that does not have to "over-tightened" to correct a leaking issue. When you are fitting yourself, or being fitting by another, take note of the tightness or discomfort of that style of nasal mask. If you wake days later with pain and redness along the sides of your nose, cheeks, bridge or upper lip or any other portion of your face - do not ignore. Call your provider or do some research. It may be time to switch to a different mask and do it early! If you love the nasal mask you are using then there are products on the market that can help such as a "RemZZZ", "Nasal Gecko Pad" or "LiquiCell Adhesive". So you may not have to switch your mask, you may just need one of these accessories to alleviate the discomfort! One problem with these accessories is that they are not typically covered by your insurance and must be private payed out of your pocket.
Another problem that nasal style of masks can propose regardless of the mask fitting tightly or not is the pressure point placed in four specific areas. These points may not ever lead to a pressure sore or associate with significant pain. However, discomfort that wakens you throughout the night can be evident, which is something I have worked through myself. The first pressure point is at the bridge of your nose. If you have a very deep bridge then it can cause issues and is easily overlooked when studying your facial features. Problems occur for patient's with a shallow bridge as well as the mask can press down causing discomfort. The second point is the skin at your cheek where the cushion presses. Some mask styles press deeply here leaving imprints in the morning which causes discomfort as well. Thirdly is the pressure point above your lip where facial hair and dentures can become a factor as well. If you are feeling uncomfortable in these areas then that is an indication of a problem that could lead to a greater issue. The fourth point (pending on the mask) is at your forehead where the support is located. This point can cause unease as the others. Most of the time it is hard to tell early if these points will be a problem. It takes careful communication and assessment from to your provider to assure the mask is the right one for you!
Now, you have made it so far into your CPAP therapy! You've endured the sleep study and received a new CPAP machine consulting with a physician and your DME. Now you are days into your nasal style of mask you've chosen and you're concerned with any number of the problems I've listed above or maybe another I've missed. Here is the part that becomes difficult. As a healthcare professional I am to tell you to clearly communicate this problem with your DME provider, physician or technician. However, even though this is the correct suggestion, it is not always the most reliable. Sometimes the fitting technician is inexperienced or the DME provider can not offer sufficient support. Sometimes the physicians office is not accustomed to positive pressure therapy so a lack of support is available. This leaves you with searching and hoping via the internet or utilizing other resources. If you have used a DME (durable medical equipment) provider or physician's office in the past and found a lack in support, try another. You have the choice to use any DME or other provider (pending your insurance coverage). Do not ignore the problem and simply suffer. Do not endure through discomfort to eventually walk away from your CPAP machine. There are so many types of traditional nasal styles that can offer a change to aid you. The problems your experiencing do not only encompass you, but your health and sometimes the anxiety/health of the person sleeping next to you! Also, the internet is a wonderful tool for suggestions and different mask types, but you'll eventually have to use some form of provider to get the supplies. However, there is wonderful information available at your finger tips.
Below is a list of some of the traditional nasal masks I have tried and suggest for patient's to use! I categorized by the manufacturer to help you if you are researching. I also want you to know that there are so many different manufacturers than these three with lots of different masks to offer. These three manufacturers are the typical styles that your local DME company would keep in stock, but not the only ones they have in stock by any means. So do not, in any way, think that these suggestions below are the only traditional nasal style of masks. There are hundreds more available.
Airfit N10 - Available in small, standard and wide sizing.
Swift Fx Nano - Available in small, standard and wide sizing.
Mirage FX - Available in small, standard and wide sizing.
Ultra Mirage - Available in standard, large, shallow and shallow wide.
Mirage Active LT - Available in small, medium, large, large wide and extra large.
Mirage Micro - Available in small, medium, large, large wide and extra large.
Ultra Mirage II - Available in standard, large, shallow and shallow wide.
Wisp - Available in petite, small/medium, large and extra large.
Pico - Available in small/medium, large and extra large.
ComfortGel Blue - Available in petite, small, medium and large.
TrueBlue Gel - Available in petite, small, medium, medium wide and large.
Easy Life - Available in petite, small, medium, medium wide and large.
Eson - Available in small, medium and large.
Zest - Available in petite, standard and plus.
Zest Q - Available in petite, standard and plus.
I hope this general information helps you in your search for a traditional nasal cushion style of mask! Sleep well!