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, or PAP therapy, can be beneficial for those living with sleep apnea. Continuous PAP machines, or CPAP machines, deliver a steady supply of oxygen at a prescribed rate throughout the night; this is considered the most effective PAP method for those with OSA. Bi-level PAP machines, or BiPAP machines, provide air at variable rates that fluctuate based on the sleeper’s breathing patterns, and are normally used to address CSA. Both CPAP and BiPAP machines require use of a breathing apparatus known as a CPAP or BiPAP mask. Nasal masks, which supply oxygen to the nasal passages but not the mouth, are the most popular type of CPAP/BiPAP mask, and are considered particularly useful for people who breathe through their noses.
This guide will look at the most common designs of nasal CPAP masks (including nasal bridge and nasal pillow models), as well as some buying considerations and our picks for the top mask models.
Designs and Features of CPAP Machines and Nasal CPAP Masks
Before we discuss nasal CPAP masks at length, let’s look at how CPAP machines are designed and how they function.
Like CPAP masks, CPAP 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 CPAP machines — as well as other treatment options — with their physician.
All CPAP 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 therapy requires 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 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 machine, follow this six-step process:
- 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.
- Plug the machine into an AC outlet.
- Check the humidifier tank to make sure it is full, and refill with distilled water as needed.
- Affix the connective hose to the mask, and ensure it is fully connected to the box as well.
- Turn on the CPAP machine.
- If necessary, adjust the settings during the night.
In terms of airflow, CPAP machines deliver oxygen at different pressurized rates; the machine owner’s physician can run tests to determine the most suitable pressure rate for him/her. 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.
Now, let’s discuss 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.
|Nasal Mask Type||Nasal Cradle (aka Nasal)||Nasal Pillow||Nasal Prong|
|Frame||Triangular frame||Two nare plugs attached linked by a vertical pillow||Two nare plugs linked by headgear|
|Coverage Areas||Entire nose, including bridge and both nostrils||Nares (nostrils) only||Nares (nostrils) only|
|Headgear||Jaw and head straps that connect behind the ears||One strap that runs beneath the nostrils and wraps around the head on both sides||One strap that runs beneath the nostrils and wraps around the head, as well as a forehead strap|
|Air Delivery||Indirect; users inhale oxygen supplied through the frame||Direct; oxygen is delivered into both nares||Direct; oxygen is delivered into both nares|
|Optimal Air Pressure||Any rate, including high pressure (14 or higher)||Low to moderate; high pressure can cause discomfort and irritation||Low to moderate; high pressure can cause discomfort and irritation|
|Price Range||$60 to $130||$80 to $100||$80 to $90|
|Ideal Sleep Position||Back or side||Back, side, or stomach||Back, side, or stomach|
|Pros||Wide model selection|
Ideal for high pressure delivery
|Lightweight and non-invasive|
Suitable for all sleep positions
|Lightweight and non-invasive|
Suitable for all sleep positions
|Cons||Bulkier and heavier than other nasal masks|
Most expensive option (on average)
|Not ideal for high pressure delivery|
High irritation potential
|Very limited selection|
Not ideal for high pressure delivery
High irritation potential
Other characteristics of nasal cradle, nasal pillow, and nasal prong CPAP masks include the following:
- May aggravate congestion: Because they require clear, unobstructed nasal passages, people who experience routine congestion (including those with allergies) may not be comfortable wearing nasal CPAP masks.
- CPAP and BiPAP compatibility: In most cases, masks used with CPAP machines can also be used with BiPAP machines, provided the connective hose is compatible with the mask’s elbow port.
- Multiple sizes: In addition to standard Small, Medium, and Large sizes, many nasal CPAP masks come in Extra Small and Extra Large sizes. Models specifically designed for male and female wearers are also available from select manufacturers, as are models made for ‘smaller’ and ‘wider’ faces. In some cases, a nasal mask will come in one universal size.
- Cleaning: CPAP masks should be cleaned multiple times per week, if not every day, using an alcohol-soaked cleaning cloth or rag. They should also be stored in dry environments where humidity is not a concern.
- Price-point: Nasal cradle masks tend to be the most expensive nasal CPAP option, although price-points may range anywhere from $60 to $130. Nasal pillow and nasal prong models are usually cheaper, and rarely cost more than $90 to $100. Please note that CPAP masks are always sold separately from CPAP machines.
Nasal CPAP Masks vs. Full Face CPAP Masks
Now that we’ve discussed the different types and design features of nasal masks, let’s compare and contrast these models with another common type of CPAP mask: the full face mask.
|CPAP Mask Type||Full face||Nasal|
|Mask Subtypes||None||Nasal cradle|
|Coverage Areas||Nose and mouth||Nose only|
|Optimal Air Pressure Rate||Low to high||Low to high (nasal cradle)|
Low to moderate (nasal pillow and nasal prong)
|Suitable for…||People who breathe through their mouths|
|People who breathe through their noses|
All sleep positions
|May Not Be Suitable for…||Side and stomach sleepers|
People who breathe through their noses
|People who breathe through their mouths|
People with allergies or other congestion issues
|Issues for Users||High air leakage potential due to larger coverage area|
May be problematic for people with facial hair
|Some users experience irritation around the nostrils|
Nosebleeds and pressure sores may occur
|Availability||Widespread||Widespread (nasal cradle and nasal pillow)|
Rare (nasal prong)
|Average Price-point||$100 to $150||$60 to $130 (nasal cradle)|
$80 to $100 (nasal pillow)
$80 to $90 (nasal prong)
Considerations for Nasal CPAP Mask Shoppers
When shopping for a new nasal CPAP mask and comparing different brands and models, here are a few key factors to keep in mind:
- Do you suffer from allergies or other forms of routine congestion? If the answer is yes, then a nasal cradle mask that supplies indirect air may be the most suitable option. People who are frequently congested may not receive sufficient air delivery from nasal pillows or nasal prongs because they are inserted directly into the nares.
- What is your ideal air pressure setting? Because they provide indirect air delivery, nasal cradle masks are suitable for all pressure rates, including high rates. However, people who require high rates of pressure may not be as comfortable with nasal pillow or nasal prong masks because air is delivered directly into the nares; if the pressure is too high, this can cause significant discomfort.
- What is your budget? Nasal CPAP masks all have comparable price-points, but nasal cradle masks (which can cost up to $150) tend to be more expensive than nasal pillow or nasal prong models, both of which are usually available for less than $100. That being said, some of the highest-rated nasal cradle models are available for $60 or less.
- What sizes are available? The vast majority of nasal CPAP masks are available in at least the three standard sizes (S, M, L); with nasal pillow masks, all three sizes will usually be included with the same purchase. Many are also available in XS and XL sizes. Alternatively, some nasal masks come in one universal size designed to accommodate most users. Female CPAP users are urged to seek out models that are designed ‘for her,’ as some models designed for universal wear may be too large. Those with relatively small or wide faces may also be more satisfied with custom-size designs.
- Is mask weight a concern? Nasal cradle masks are light compared to full face CPAP masks, but these models are significantly heavier and more invasive than nasal pillows or nasal prong masks.
- What is your headgear preference? Nasal cradle masks tend to have multiple straps, whereas most nasal pillow and nasal prong models have one strap that runs beneath the nostrils. The latter is considered less invasive, but the former may provide more support around the forehead.
- How is the headgear secured? Hook-and-loop closures are common, but these may come undone during the night if they are secured too tightly. Some CPAP users prefer more sophisticated closures, such as cinchable straps, buckles with adjustable dials that tighten or loosen the straps, or ‘quick clips,’ which hook into grommets in the mask frame and can be removed easily and quickly.
- Is headgear included with the mask? Headgear is usually included with the mask frame, but may be sold separately — check the product specs to make sure before finalizing your purchase.
- Does the headgear feature a forehead support strap? Some mask wearers prefer the added stability of a strap that wraps around the forehead — but this feature can also limit one’s line of sight.
- What is the cushion material? Most nasal CPAP masks feature cushions made from silicone, which is soft and cool to the touch, but some models may feature gel, foam, or cloth cushions.
- Is the cushion replaceable? The cushion should be replaced every few months, and most nasal CPAP masks feature detachable cushions for easy swapping.
- What are the terms of the mask’s return policy/warranty? Some nasal CPAP masks come with product warranties; these typically last at least 90 days, but rarely exceed two years in length. In some cases, the frame and headgear will be covered under separate warranties. In lieu of a warranty, some retailers offer free returns for defective products. Some retailers require customers to purchase return insurance to prepare for this contingency.
Best Nasal CPAP Masks: Lower-cost Brands and Models
Now, let’s look at the best nasal CPAP masks according to customers and owners. The table below lists the five top-rated nasal CPAP masks that are currently available for purchase with a medical prescription at a cost of $75 or less. All satisfaction ratings are generated from authentic customer and owner experiences.
|Brand/Model||Aloha||Eson||FlexiFit HC407||Opus 360||Zest Q|
|Manufacturer||InnoMed/RespCare||Fisher & Paykel||Fisher & Paykel||Fisher & Paykel||Fisher & Paykel|
|Mask Type||Nasal pillow||Nasal cradle||Nasal cradle||Nasal pillow||Nasal cradle|
|One size ||Small|
|‘For Her’ Size Available?||No||No||No||No||Yes|
|‘Small’ and ‘Wide’ Sizes Available?||Yes||No||No||Yes||Yes|
|Headgear Closure||Cinchable straps||Hook-and-loop closures||Quick clips||Hook-and-loop closures||Hook-and-loop closures|
|Forehead Support Strap?||No||Yes||Yes||No||Yes|
|Tuck Customer Satisfaction Rating||93% (405 customer reviews)||91% (166 customer reviews)||90% (476 customer reviews)||89% (522 customer reviews)||92% (119 customer reviews)|
Best Nasal CPAP Masks: Higher-cost Brands and Models
The next table lists our top-rated models that are available for purchase with a prescription at a cost of more than $75.
|Brand/Model||AirFit P10||Mirage Activa ||Nasal Aire II||Swift FX||Ultra Mirage II|
|Mask Type||Nasal pillow||Nasal cradle||Nasal prong||Nasal pillow||Nasal cradle|
|‘For Her’ Size Available?||Yes||No||No||Yes||No|
|‘Small’ and ‘Wide’ Sizes Available?||No||Yes||Yes||Yes||Yes|
|Headgear Closure||Cinchable straps||Hook-and-loop closures||Cinchable straps||Cinchable straps||Hook-and-loop closures|
|Forehead Support Strap?||No||Yes||No||No||Yes|
|Tuck Customer Satisfaction Rating||92% (930 customer reviews)||90% (603 customer reviews)||86% (338 customer reviews)||92% (1,298 customer reviews)||91% (754 customer reviews)|
Additional Tuck Resources
For more information about sleep apnea and CPAP/BiPAP therapy, please visit these pages on Tuck.com: