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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 two different rates, one for inhalation and another for exhalation, which eases breathing for sleepers. BiPAP machines 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.
Nasal masks (also known as nasal cradle masks) are popular because they provide a tight seal around the nose to prevent air leakage and offer chin support to prevent the mouth from opening while breathing. Our Editor’s Pick for Best Nasal Mask is the Fisher & Paykel Eson 2. This mask is designed with a seal that automatically adjusts to the wearer’s facial dimensions, resulting in a more comfortable fit.
The mask’s headgear is also highly advanced and designed to accommodate different wearer’s, regardless of their fit preferences. The built-in air diffuser – which prevents air from blowing onto the wearer’s sleep partner – is washable, as well.
The Eson 2 has a reasonable price-point, considering its innovative design. It is also backed by a 90-day warranty.
Our top pick for nasal pillow masks is the ResMed Swift FX. Unlike many competing nasal pillow models, this mask offers comfort and easy breathing at most pressure settings. It also includes flexible pillows on both sides to alleviate irritation around the nostrils.
Thanks to its simple design, the ResMed Swift FX does not limit movement or range of motion very much. It also comes equipped with air vents which act s diffusers by isolating the air and preventing noisy disruptions for sleep partners.
The mask comes with Small, Medium, and Large pillows for wearers who don’t know their exact fit. It is backed by a 90-day warranty.
Many nasal CPAP masks cost at least $90, and some are priced at $120 or more. The DeVilbiss Aloha Nasal Pillow Mask, on the other hand, is widely available for less than $70. However, it offers the same adjustable comfort and airflow delivery as most of its higher-cost competitors.
The mask is designed with a ball-and-swivel joint at the hose connection, allowing sleepers in any position to receive uninterrupted airflow. The angle of the pillows can also be adjusted for maximum comfort. The soft, breathable headgear can be customized, as well.
The hose can be worn over the head or chest, allowing wearers to find their most comfortable position. The Aloha Nasal Pillow Mask is backed by a 90-day warranty.
Many women with sleep apnea find that ‘unisex’ nasal CPAP masks tend to favor men’s faces in terms of length and width. These masks also have back-strap headgear that interferes with longer hair.
Our Best Mask for Women pick, the ResMed Swift FX Bella Nasal Pillow Mask, addresses these issues. The flexible frame contours to the wearer’s face, regardless of their specific dimensions. Additionally, the looped headgear fits snugly around the wearer’s ears and won’t interfere with longer hair.
Customers can choose from Extra-Small, Small, and Medium pillow sizes. The ResMed Swift FX Bella Nasal Pillow Mask is backed by a 90-day warranty.
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.
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:
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.
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:
Generally speaking, three types of nasal CPAP masks are available:
Key similarities and differences between these three designs are outlined in the table below.
|Type of Nasal CPAP Mask||Nasal (aka Nasal Cradle)||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 pressure settings||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|
|Average 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:
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 Nasal pillow Nasal prong|
|Coverage areas||Nose and mouth||Nose only|
|Optimal pressure settings||Low to high||Low to high (nasal cradle) Low to moderate (nasal pillow and nasal prong)|
|Suitable for...||People who breathe through their mouths Back sleepers||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 range||$100 to $150||$60 to $130 (nasal cradle) $80 to $100 (nasal pillow) $80 to $90 (nasal prong)|
When shopping for a new nasal CPAP mask and comparing different brands and models, here are a few key factors to keep in mind:
The prescription requirements for nasal CPAP masks and other components can be somewhat confusing. In this next section, we’ll address some common prescription-related questions for first-time nasal mask buyers.
|Do I need a prescription for CPAP machines?||A prescription is not required for the entire CPAP machine – just three main components. Sleep apnea patients need a doctor's prescription to legally purchase CPAP airflow generators, humidifiers, and face masks. The U.S. Food and Drug Administration (FDA) categorizes these three parts as Class II medical devices. Other CPAP machine parts, including connective hoses and air filters, do not hold this FDA classification. Anyone can buy them over the counter.|
|Why do I need a prescription for these CPAP components?||CPAP machines – as well as BiPAP and APAP machines – are customized for individual users. Doctors prescribe airflow levels based on patient assessments that determine optimal pressure setting(s). If a patient uses a machine that is not calibrated to the correct airflow level, he or she may not receive the treatment they need. Another reason is insurance. Patients don't require medical insurance to buy CPAP equipment, but insurance companies demand a prescription to cover costs for people who can't afford them out-of-pocket.|
|Will anyone sell me a Class II medical device without a prescription?||Yes, but this practice is illegal. The FDA regulates sales of Class II medical devices. Those who sell these devices must receive FDA approval to do so. According to current FDA regulations, medical device sellers must also collect a prescription from customers seeking CPAP generators, humidifiers, or face masks. Most non-prescription CPAP sales are facilitated online . In addition to being illegal, transactions of this nature usually involve used, refurbished, and/or modified machines. These devices can pose health risks to the buyer due to improperly calibrated equipment, as well as exposure to germs and bacteria from previous users. Quality assurance is another consideration since buyers have no assurance the machine operates properly and will not, under any circumstances, receive warranty coverage.|
|How do I obtain a prescription for FDA-regulated CPAP equipment?||In order to qualify for a CPAP prescription, patients must receive a sleep apnea diagnosis from one of the following licensed or certified professionals:
|What does my CPAP prescription need to say?||In order to legally purchase a CPAP machine, the prescription must include the following: