How to Choose a CPAP Mask
Sleep & CPAP Guide · 9 min read
How to Choose a CPAP Mask
The mask, not the machine, is what usually decides whether CPAP works. Here's how to choose between nasal pillows, nasal, and full face, in plain language, from our team.
CPAP machines rarely fail. Masks are what make people give up. If therapy isn't working, or you've quietly stopped wearing it, the mask is almost always the place to look first. Choosing the right type comes down to how you breathe and how you sleep, not which brand is best.
In a hurry? The short version
- There are three types: nasal pillows, nasal, and full face. Most people do well starting with a nasal mask.
- If you breathe through your mouth at night, a nasal mask alone will leak. You need a full face mask or a chin strap.
- Size is per model, not universal. A Medium in one mask tells you nothing about your size in another.
What a CPAP mask does
Your machine sets the pressure. The mask's only job is to deliver it to your airway without leaking. When a mask leaks, the machine pushes harder to compensate, air dries your nose and mouth, and the therapy stops doing what it was prescribed to do.
Every CPAP mask has:
- A silicone cushion
- A frame
- Adjustable headgear
- An elbow connector
- Vent holes
- Quick-release clips
Those vent holes continuously release the carbon dioxide you exhale. They look like a flaw. They are essential, and they must never be blocked.
⚠️ Three habits worth repeating
- Never block the vents. Don't tape them, and don't let a pillow or blanket cover them.
- Tighter is not better. Over-tightening deforms the cushion and creates leaks. If you're cranking the straps to stop a leak, the mask is the wrong size or the cushion is worn out.
- Waking with a bone-dry mouth usually means mouth leak, not a humidifier problem. That's a signal to talk to your provider.
The three types of mask
Nasal pillows
Two soft silicone prongs seal at the nostril openings. Barely anything touches your face, so you can wear glasses, read, or watch TV right up until you fall asleep. The usual choice for people who feel closed in by larger masks, and the beard-friendly option, since nothing has to seal against facial hair. The trade-off is that air goes straight into the nostrils, which can feel harsh and drying at higher pressures.
Nasal masks
A triangular cushion seals over the bridge and sides of the nose. The airflow feels more diffuse and natural than pillows, which makes nasal masks the better fit as pressure climbs. This is the category most people are steered toward first, and most stay there. A newer variation, the nasal cradle, rests under the nose rather than over it, so there's no pressure on the bridge and no red mark between the eyes in the morning.
Full face masks
These cover the nose and mouth together, and they exist for a specific reason. If your mouth opens during sleep, pressurized air escapes straight out of it and therapy fails, no matter how well the nasal seal is holding. A full face mask solves that directly. It's also the practical choice when allergies or a deviated septum mean you can't rely on nasal breathing.
| Nasal pillows | Nasal mask | Full face | |
|---|---|---|---|
| What it covers | Nostril openings only | The nose | Nose and mouth |
| Best for | Lower pressure, glasses, facial hair | Most users | Mouth breathers, congestion |
| Field of view | Almost completely clear | Mostly clear | Blocked |
| Side sleeping | Excellent | Good | Harder, bulk can shift the seal |
| Main drawback | Nasal dryness at higher pressure | Useless if your mouth falls open | Most leak points |
Choose nasal pillows if you're on a lower pressure and want the least intrusive option. Choose a nasal mask if you want a comfortable all-rounder. Choose full face if your mouth opens at night.
6 questions to ask before you buy
Do you breathe through your mouth at night?
The single most important question. If you wake with a dry mouth, or a partner says your mouth hangs open, a nasal mask on its own won't hold therapy. Plan on a full face mask, or a nasal mask paired with a chin strap.
What pressure are you prescribed?
Higher pressures are generally easier to tolerate with a nasal or full face mask, which spread the airflow. Nasal pillows can feel like a jet at the top of the range. Your sleep study set this number, so check it before you shop.
How do you sleep?
Side and stomach sleepers do better with a low-profile mask that won't get levered off by the pillow. Look for a short tube that routes over the top of the head rather than hanging off the front of your face.
Do you read, watch TV, or wear glasses in bed?
A mask that blocks your line of sight quietly makes you resent wearing it. Nasal pillows and nasal cradles leave your field of view essentially open.
Do you have a beard or mustache?
Facial hair breaks the seal on any mask that presses a cushion flat against skin. Nasal pillows sidestep the problem entirely, because they seal inside the nostrils.
Is your current mask leaking, or just old?
Before replacing the whole mask, check the cushion. Silicone hardens and loses its shape with use, and a tired cushion is the most common cause of a leak that appeared out of nowhere. A replacement cushion costs a fraction of a full mask.
Getting the size right
This is where most of the frustration lives. Mask sizes do not transfer between models or brands. A Medium in one manufacturer's nasal mask may be a Small in another's, and some masks ship with more than one cushion size in the box for exactly this reason.
Nearly every manufacturer publishes a printable fitting template. Print it at 100% scale, not "fit to page," which silently shrinks it, then measure against it. Then fit the mask the way you'll actually use it:
- Lie down first. Your face changes shape when you do. A mask fitted sitting upright often leaks the moment you're horizontal.
- Turn the machine on while you adjust. An unpressurized mask tells you nothing about how it seals under pressure.
- Start loose and tighten gradually, stopping the moment the leak stops.
- Check for red marks in the morning. Light marks that fade quickly are normal. Deep marks or soreness mean the mask is too tight or the wrong size.
Features that matter most
- Cushion material and shape. Where the mask meets your face determines comfort more than anything else on the spec sheet.
- Tube position. Top-of-head routing keeps the hose out of the way and suits side sleepers. Front-facing tubes are simpler but tug more.
- Headgear adjustment. Magnetic or quick-release clips make a real difference if you get up during the night.
- Vent noise. Diffused venting directs air away from a bed partner instead of at them.
- Number of parts. Fewer pieces means faster cleaning, and a mask that's easy to clean is one you'll actually keep clean.
How often to replace things
Mask parts are consumables. They wear out on a predictable schedule, and most insurance plans expect replacement at roughly these intervals:
| Part | Typical replacement | Sign it's overdue |
|---|---|---|
| Cushion or pillows | Every 2–4 weeks | Leaks, hardening, discoloration |
| Headgear | Every 6 months | Straps no longer hold tension |
| Mask frame | Every 3–6 months | Cracks, loose clip connections |
| Machine filters | About every 30 days | Visible dust, grey discoloration |
Stretched-out headgear is a leak source people rarely suspect, because the failure is gradual. You compensate by tightening, week after week, until the mask is uncomfortable and still leaking.
Which mask is right for you?
- New to CPAP: a nasal mask, which suits the widest range of pressures and sleeping positions.
- Feel closed in: nasal pillows, the least intrusive option available.
- Mouth falls open at night: a full face mask, or a nasal mask with a chin strap.
- Sore nose bridge: a nasal cradle that rests under the nose instead of over it.
- Wear glasses or read in bed: nasal pillows or a cradle, for a clear field of view.
- Mask fits but leaks: a replacement cushion before a new mask.
Complete your sleep therapy setup
Shopping for a mask? These usually come up too:
- CPAP accessories. Cushions, headgear, tubing, and filters.
- CPAP machines. Fixed-pressure and auto-adjusting units.
- Humidifiers. For nasal dryness at higher pressures.
- Snoring aids. Chin straps and related support.
- All sleep & CPAP. Browse the full sleep therapy range.
Frequently asked questions
Can I use a nasal mask if I breathe through my mouth?
Only with help. A chin strap can hold the jaw closed for some people, but it doesn't work for everyone. If your mouth consistently falls open, a full face mask is the more reliable answer. Ask your provider which is appropriate for you.
Why did my mask suddenly start leaking?
Usually a worn cushion. Silicone hardens over weeks and stops conforming to your face. Check the cushion first, then whether the headgear has stretched. Gaining or losing weight can also change how a mask fits.
Can I switch mask types on my own?
You can change masks, but tell your provider, especially when moving between nasal and full face. Your prescribed pressure was set with a delivery method in mind, and some machines need a setting adjusted to match.
How do I stop red marks and sore spots?
Loosen the headgear first, since most marks come from over-tightening. If loosening causes leaks, the mask is the wrong size or the cushion is worn. Persistent soreness, or any broken skin, is worth raising with your provider.
Does insurance cover mask replacement?
CPAP masks and supplies are generally classified as durable medical equipment and are often covered on a replacement schedule, though the specifics vary widely by plan. Confirm your coverage and replacement intervals with your insurer before ordering.
How should I clean my mask?
Wash the cushion daily in warm water with mild, unscented soap, and let it air dry out of direct sunlight. Skip harsh detergents and alcohol wipes, which degrade silicone. Follow your manufacturer's instructions for the frame and headgear.
Not sure which type fits you? Talk to a person.
Locatel carries CPAP masks, cushions, headgear, and filters, with specialists who sort out fit and leaks every day, at our Hallandale Beach and Miami locations, and shipping across the U.S. and internationally. Bring your prescribed pressure and your current mask and we'll help you work out what's going wrong.
📞 (954) 416-1200 ✉️ Email usShop CPAP accessories · Browse all sleep & CPAP
A note from our team: If you've given up on CPAP because of the mask, you're in good company, and it's usually fixable. Bring the mask in. Most of the time it's a cushion, a size, or a strap that's been tightened a little more each week for a year.
This guide is for general informational purposes only and is not medical advice. CPAP therapy is prescribed, and your pressure settings and mask type should be confirmed with your healthcare provider or sleep specialist. Do not change your prescribed settings on your own.
Written by Maria Gabriela Ruah Lopez
