Jay Summer is a health content writer and editor. She holds a B.S. in psychology and master's degrees in writing and public policy.
Sleep apnea is a breathing disorder that affects millions of Americans, many of whom use a continuous positive airway pressure (CPAP) machine to treat their condition. CPAP treatment requires the use of a mask, so many people believe CPAP users must sleep on their back because a mask is too bulky to let them comfortably sleep on their side or stomach. However, there are several designs of CPAP masks, some of them bulkier than others. While some CPAP users must use a specific mask type, others are free to choose a mask based on their preferred sleep position.
It is crucial to follow the advice of your sleep specialist when choosing a CPAP mask. Before you switch mask types, speak to them to learn more about whether your preferred option might work for you. Each mask type is shaped the way it is for a reason, and not all masks are appropriate for all CPAP users.
The three most common CPAP mask designs are full-face, nasal, and nasal pillow masks. Full-face masks are the bulkiest, as they cover both the nose and the mouth, while nasal masks cover only the nose. Nasal pillow masks are the least obtrusive, as they cover only the nostrils and do not have a hard shell.
Since CPAP masks require a tight seal to avoid air leaks, sleeping in a way that presses on the mask is more than uncomfortable — it can also compromise your treatment’s efficacy. A CPAP mask’s headgear can also interfere with sleep, particularly if they have hard plastic buckles or stiff anchor straps. When choosing a CPAP mask, you should consider both the footprint of the mask — length and width, as well as depth — and where the headgear rests against your face. The goal is to find an effective mask that is still comfortable for you to sleep in.
Sleeping on your side is one of the best positions for sleep apnea treatment, since it prevents gravity from impacting your airway the way it does when sleeping on your back or stomach. Unfortunately, side sleepers sometimes struggle to find the right CPAP mask.
Nasal pillow masks are a good option for side sleepers who can tolerate them, as their low profile rests higher than the pillow itself. (Some side sleepers do turn their face against the pillow, but nasal pillow masks usually keep their seal even then.) Nasal masks, which cover all or part of the nose, are another option that works for many side sleepers. The best models are those with excellent seals, as well as soft and adjustable headgear. These features help prevent air leaks, but side sleepers may still require a CPAP-friendly pillow to accommodate the bulk of even a nasal mask.
CPAP users who sleep on their back have their choice of mask styles, since this position accommodates even full-face masks without difficulty. While this may make sleeping on your back the best position if you use a CPAP mask, sleeping this way can cause airway collapse due to gravity. If your doctor is aware that you sleep on your back and has not encouraged you to change your sleeping position, you will likely be comfortable with any mask that is effective and fits any other needs you may have. The position also makes it difficult to dislodge your mask, though some back sleepers may struggle with single-strap headgear.
Stomach sleeping is the rarest sleep position, and people who sleep on their stomach have unique concerns when choosing a CPAP mask. The position causes most masks to press into the face, causing discomfort and frequent air leaks. Depending on the size of your mask, it may also force your head into a position which places stress on the neck and can cause next-day pain or stiffness.
Due to these factors, most people are only able to sleep on their stomach if they use a nasal pillow mask. The low profile of nasal pillows makes them ideal for this, as they are unlikely to become dislodged or cause pain regardless of your sleep position. However, even people who use a nasal pillow mask should ensure their actual pillow accommodates the mask. Some masks also have tube positioning along the temples, which can cause air restriction depending on your position and the firmness of your pillow.
CPAP masks, like CPAP machines, require a prescription. Despite this, there are multiple options for where to buy your CPAP mask. Online retailers do still require a prescription, which they usually check by having you upload or fax them the prescription. Once your prescription is approved, you will be able to make your purchase.
Online retailers usually have the widest selection of the best CPAP machines and CPAP masks, but brick-and-mortar medical equipment retailers are also popular options and may be more convenient if you need a mask immediately. Finally, many sleep clinics and specialists sell a limited range of CPAP masks. Their prices are usually higher, but purchasing through your sleep specialist allows them to better track your treatment.
Not all CPAP users are able to use the full range of CPAP mask types, and your choice of CPAP mask must follow the advice of your sleep specialist. If the mask you need to use makes it difficult to sleep in your preferred sleep position, a CPAP pillow might offer a solution. These pillows are shaped to accommodate masks — including bulkier masks — better than a traditional pillow, even while sleeping on your side. Depending on the model, they may also offer improved cervical support to keep you from dislodging your mask or experiencing neck pain.
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