Buying Guide – How to Shop for a Nasal CPAP Mask
More than 20 million Americans live with sleep apnea, a condition characterized by temporary loss of breath during sleep. Sleep apnea episodes typically last no longer than 30 to 40 seconds, but people with apnea may experience more than 100 episodes on a nightly basis.
Individual symptoms vary, but physicians have pinpointed two general types of sleep apnea: obstructive sleep apnea (OSA), which occurs when a physical impediment (such as swollen tonsils) hinders air circulation in breathing passages; and central sleep apnea (CSA), causes by improper signals between the brain the muscles that control breathing. Positive air pressure therapy is often used to treat the symptoms of sleep apnea. Continuous positive air pressure (CPAP) therapy is often prescribed for OSA, while bi-level positive air pressure (BiPAP) therapy is usually used to treat CSA.
These therapies require use of a special machine that draws in outside air, humidifies it, pressurizes it to a certain setting, and delivers it to sleepers via a connective hose and face mask. Many sleepers who receive CPAP or BiPAP therapy prefer nasal CPAP masks because they are lightweight and non-invasive compared to full face masks.
This guide will discuss nasal CPAP masks in terms of construction and pricing. We’ll also cover the primary differences between nasal and full face masks, as well as prescription requirements for shoppers.
CPAP and BiPAP Machines
Before we discuss nasal CPAP masks at length, let’s look at how CPAP and BiPAP machines are designed and how they function.
Like CPAP masks, CPAP and BiPAP machines require a doctor’s prescription and are never available over the counter. Because there is no established cure for sleep apnea, people with OSA or CSA should discuss these machines – as well as other treatment options – with their physician.
All CPAP and BiPAP machines are designed differently, but generally feature the following components:
- Airflow generator: The generator and fan are contained in a small ‘box’ that can fit on a nightstand or bedside surface. Dimensions vary by model, but most generator boxes measure about 10 inches long, six inches wide and six inches high. When the CPAP machine is switched in the on position, the generator and fan will absorb air from the room and pressurize it based on the prescribed rate.
- Humidifier: CPAP and BiPAP therapies require humidified air. Humidifiers perform this function using distilled water that is stored in a tank before it is supplied to the machine’s user. Humidifiers may be built-in or external, and some CPAP and BiPAP machines neither come with nor utilize a humidifier. The water tank generally holds between 300 and 450 milliliters, depending on the model.
- Air filter: To further purify the air, a filter collects dust and other allergens as the generator sucks in air from the outside. Air filters are replaceable, and should be swapped out on a regular basis to ensure the air is contaminant-free.
- Connective hose: The connective hose links the generator box to the mask, where it attaches to the elbow port. The hose is usually made from transparent plastic, and measures between five and six feet long.
To operate a CPAP or BiPAP machine, follow this six-step process:
1. Place the machine on a level surface where it will remain upright for throughout the night. This surface should be less than five feet from the user’s face to ensure the connective hose won’t be too tight, and that the box won’t be pulled onto the floor if the user shifts positions.
2. Plug the machine into an AC outlet.
3. Check the humidifier tank to make sure it is full, and refill with distilled water as needed.
4. Affix the connective hose to the mask, and ensure it is fully connected to the box as well.
5. Turn on the machine.
6. If necessary, adjust the settings during the night.
In terms of airflow, CPAP machines deliver oxygen at a single pressure rate. This rate is determined by the sleeper’s physician, who documents the setting in their prescription. BiPAP machines deliver air at two pressure rates, one for inhalations and another for exhalations, to ease breathing for sleepers.
Airflow output is measured in centimeters of water, or cmH20. Most apnea patients require anywhere from 6 to 14 cmH20, and machines are usually made to deliver 4 to 20cmH20 of air in one centimeter increments, depending on the prescribed rate.
Designs and Features Nasal CPAP Masks
The term ‘nasal CPAP mask’ refers to any positive air pressure mask that exclusively delivers oxygen to the nasal passages. These are distinct from full face CPAP masks, which deliver oxygen to both the nose and mouth, and oral masks that only supply air to the mouth. It’s important to note that nasal CPAP masks can also be used with most BiPAP machines — but in either case, a doctor’s prescription is required to purchase a PAP mask.
All nasal CPAP masks are different, but they generally feature the following components:
- Frame: This is the ‘mask’ component that seals around the nose and supplies oxygen to the nasal passages.
- Cushion: To improve comfort and help alleviate pressure, nasal CPAP masks feature thin membranes along the edges of the frame. Most mask cushions are made from silicone, but this component may also be made of gel, foam, or cloth. The cushion is usually replaceable, and should be swapped out every few months; Medicare allows recipients to replace their CPAP mask cushion every three months.
- Headgear: The straps that fit around the head and hold the frame in place are known as ‘headgear.’ Most nasal cradle and nasal prong masks have two straps — one that runs along the jaw on both sides and connects at the back of the head parallel to the ears, and another that wraps around the forehead and links to the jaw strap behind the ears. Nasal pillow masks tend to have one strap that runs beneath both nostrils and connects behind the ears. The straps may be made of fabric or silicone, and secured with buckles, hook-and-loop closures, or ‘quick clips’ that allow the wearer to unclip and remove the mask more easily.
- Elbow port: Named for its right-angle shape, the elbow port is attached to the front of the frame and is used to connect the mask to the CPAP machine generator via the connective hose (more information about CPAP machine parts below). The elbow port may feature buttons on the sidewalls for easier connectivity, and often swivels to accommodate different sleep positions.
Generally speaking, three types of nasal CPAP masks are available:
- Nasal cradle: The first CPAP masks utilized this design, and it remains the most popular choice to this day; the design is often referred to simply as ‘nasal CPAP mask.’ Nasal cradle CPAP masks form a triangular seal around the nose that extends to the upper lip without covering the mouth. Some nasal cradle masks feature chin straps designed to keep the jaw closed, and can be beneficial for people who tend to sleep with their mouths open.
- Nasal pillow: Rather than covering the entire nose like nasal CPAP masks, nasal pillow masks feature two seals around the nares, or openings, of both nostrils for direct air delivery. The nares are held in place by a cushion, or pillow, for added stability and comfort. Nasal pillows are considered the lightest and most compact of the three nasal mask types, and they usually have minimal headgear as well.
- Nasal prong: Like nasal pillows, nasal prong masks are lightweight, non-restrictive, and designed to form seals around both nares. These masks connect to headgear that wraps around the crown of the head and the forehead. Nasal prong masks are not commonly used, and their availability is somewhat rare compared to nasal and nasal pillow models.
Key similarities and differences between these three designs are outlined in the table below.