CPAP Masks: A Buyer's Guide for 2021
Choosing a CPAP mask is the most important purchasing decision in determining success with therapy for obstructive sleep apnea. The CPAP mask links the user to the CPAP machine, and the fit and comfort of the mask is the number one deciding factor in whether someone will stick with CPAP therapy. There are so many types of CPAP masks available, and it can be challenging to determine what might benefit you the most.
This guide covers a range of high performing CPAP masks and includes traditional style masks that have proven themselves as product leaders year after year as well as newer masks with fresh, innovative designs. All the masks in this guide are worth considering whether you are looking to purchase your first mask or are a long time CPAP user looking to buy a back-up mask or try something new.
CPAP masks have three primary components: a frame, a cushion, and headgear. The frame holds the cushion. The cushion rests on the face and is usually made with a soft silicone or gel-type material. The headgear attaches to the frame and holds the cushion and frame in place.
Masks come in different anatomical shapes and sizes. Nasal masks and nasal pillows do not cover the mouth, while full face masks do cover the mouth. The right size mask will not leak or move too much and will also not push against your skin too much.
- High-Performance Nasal Masks and Nasal Pillows
High-Performance Nasal Masks and Nasal Pillows
Not long ago, nasal CPAP always involved a mask with a triangular cushion that sat on the bridge of the nose and above the upper lip. Then nasal pillows came along and disrupted the market. Nasal pillows fit into the nostrils and seal around the base of the nose. Nasal pillows are lighter than traditional nasal masks and do not block vision or let air flow into the eyes. For many people, nasal pillows were a game-changer, and they transitioned to nasal pillows without ever looking back. Other CPAP users really wanted to wear nasal pillows, but they found that they did not like the feeling of air delivery straight up into the nose or suffered from other complications such as nasal chafing and dryness.
The makers of CPAP masks keep trying new things, though, and as we enter a new decade, nasal CPAP interfaces come in a variety of designs that range from the traditional, triangular over the nose mask to slim under the nose devices that cradle the nostrils and barely touch the rest of the face. In between are nasal pillows and nasal masks that sit low on the nose and use a smaller frame or less complicated headgear.
The best CPAP mask for anyone is the one they will wear every night. The six nasal and nasal pillow masks in this guide span the continuum of designs. Truthfully, there is no one best design and it is a very personal decision. Many people prefer the heftier, traditional nasal masks, while others enjoy and benefit more from ultra-minimalist designs.
The ComfortGel Blue Nasal Mask has been around for many years and is a tried and true favorite of many CPAP users who prefer the sturdy, stable fit of a traditional nasal mask. It is also one of the least expensive masks available today, making it one of the best values on the market.
The ComfortGel Blue covers the entire nose, resting at the bridge of the nose and above the upper lip. The nasal cushion has two layers, a silicone shell and a squishy blue gel outer layer that conforms to the shape of the face to create an individualized seal. The ComfortGel Blue also has a support arm at the top of the frame (called the Stability Selector tool) that lets the user alter the angle of the cushion to seal leaks at the bridge of the nose or under the nose around the lip.
The headgear is wide with four points of attachment and ensures a reliable, stable fit. Ball and socket connections clip the headgear to the mask and are large enough that they will not frustrate someone with fine motor issues.
The ComfortGel Blue has a plastic stability bar that runs from the bridge of the nose to a silicone forehead pad. The stability bar prevents the user from wearing glasses and can trigger claustrophobia in some patients.
- Inexpensive ($33)
- Solid, stable fit
- Stability Selector tool to adjust the cushion angle to reduce leaks
- Gel cushion conforms for a personal fit and is gentle on the face
- Philips Respironics has discontinued manufacturing so availability may eventually be an issue
- Line of sight is obstructed
Philips Respironics DreamWear nasal mask is a minimalist mask with a nasal cushion that closes around the bottom of the nostrils like nasal pillows. Unlike nasal pillows,though, nothing rests inside the nostrils. The bridge of the nose, the forehead, and the upper lip are all untouched by the nasal cushion and the frame. Nothing on the minimalist DreamWear obstructs vision or is likely to trigger claustrophobia.Although glasses can rest on the bridge of the nose, the arms on the glasses will need to go under or over the frame.
The circuit from the CPAP tubing connects at the top of the head instead of at the bottom of the cushion. The DreamWear has a hollow silicone frame that conducts airflow from the machine to the nasal cushion. Air flow enters at an elbow at the crown of the head and flows down the cheeks to the cushion. This bit of innovation successfully keeps the weight of the circuit off the mask and stows the tubing out of the way during sleep.
Most of the mask's stabilization comes from the pliable, silicone frame which sits low along the back of the head. In 2019, Philips Respironics modified the headgear from the original design, adding eyeglass like arms to the sides of the headgear to remedy problems with headgear slippage. The DreamWear headgear "with arms" is backward compatible with the original DreamWear frame so existing DreamWear nasal mask wearers can purchase just the updated headgear.
The DreamWear comes in three sizes of frames and four sizes of nasal cushions. The only wide option is a Medium-Wide size so people with shorter but wider noses may miss out on the best fit. Philips Respironics sells the DreamWear in FitPacks that combine two sizes of frames with a few sizes of cushions, a consumer-friendly packaging option that lets the user try different size combinations at home in their own bed.
The DreamWear Silicone Nasal Pillow mask is a 2020 update to the original DreamWear Gel pillow mask. Constructed from 100% silicone, the DreamWear Silicone Nasal PIllows fit and seal better, with less shifting and less friction. Philips Respironics also added a 4th nasal pillow size to meet the needs of more people. The Silicone Pillow mask comes in four sizes: small, medium, wide and medium-wide.
The headgear and the frame with the DreamWear Silicone Pillows are identical, of course, to the headgear and frame with the DreamWear Nasal Mask with Arms. Three sizes of frames are available, as are three sizes of pillows.
The modularity of the DreamWear is a fantastic feature. To check out the Silicone Pillows if you already own a DreamWear frame, just purchase the Silicone Pillow cushion. To upgrade to the Silicone Pillows from the original Gel Pillows, just purchase the Silicone Pillow cushion.
- Over the head connection keeps tubing out of the way and eliminates drag on the mask
- Overall minimal contact design whether used with the nasal cushion or nasal pillows
- Clear line of sight
- Modular designs let you swap out the nasal cushion for nasal pillows or vice versa
- FitPack purchasing option ensures you get the right size frame and cushion or pillows for your face and nose
- Quite a bit of silicone touches the face, though fabric sleeves are included
- Some people dislike the feel or noise of air traveling down the sides of the frame
- Limited wide sizing for broader noses
The next nasal mask in this guide of top picks for 2021 is the ultra-minimalist ResMed N30. The N30 is a nasal cradle mask that uses an under the nose cushion. The N30 weighs only 2 ounces and connects to the user with nothing but a split strap elastic band.
The N30's nasal cradle cushion has a crescent shape, so it rests under the nose but curves at the sides to complete the seal. The curved sides support side sleeping by keeping the cushion out of the zone of compression. The curved sides also bumper the wearer from feeling what little plastic there is in the mask.
ResMed advertises the N30 as going on like a pair of swimming goggles, and that is an apt description. Hold the nasal cushion under the nose, pull the single strap headband over the head, and you are done. The headband is elastic across the back of the head and stretches to accommodate various head sizes. The non-elastic section of the headband that crosses the cheeks is a bit thicker to reduce slippage. A single buckle on the head strap allows for length adjustments. The only other way to adjust the fit of the N30 is to alter the distance between the split strap band behind the head.
The CPAP tubing connects to a length of flexible tubing under the nasal cradle. While this point of connection does tug on the cushion somewhat while sitting up, the drag neutralizes when lying down.
The N30 is astonishingly light and easy to use and stays in place surprisingly well. The nasal cradle only comes in three sizes, though, small, medium, and small-wide. ResMed claims that one of the three N30 cushions will fit 2/3 of people. CPAP users with longer or broader noses may land in that 1/3 group for whom it's not a great fit.
- Weighs just 2 ounces
- Nothing to hook or clip together when putting on the mask
- Ultra-minimalist design with minimal facial contact from cushion and headgear
- Almost no plastic, and there is nothing hard against the face regardless of sleeping position
- Limited adjustment options may make it difficult to fit larger or smaller heads
- Limited cushion sizes: no medium-wide, or large options
- Users may have trouble keeping a good seal at very high CPAP settings
The N30i from ResMed is a hybrid under the nose nasal mask that cannot help butremind you of the DreamWear. An under the nose nasal cushion links the two sides of a flexible, pliant silicone frame that circles the sides of the face and the top of the head. An elbow connection at the top of the frame near the crown of the head connects to the CPAP tubing. Flow travels through the frame from the elbow inlet to the cushion. A swath of cloth headgear across the back of the head holds the frame to the face. The center of the face is mostly untouched except where the nasal cushion cradles the nose. Accordion ribbing across the crown of the head lets the stretchable frame repeatedly alter its fit during movement. The silicone frame flattens out a bit against the sides of the face. Glasses can perch on your nose and the arms of the glasses will rest firmly under the flattened sections of the frame.
The frame comes in a choice of two sizes, while the nasal cushion is available in four sizes, two of which are wide variants. The length and width of the nose determine the best size of an under the nose nasal cushion so the inclusion of two wide sizes is a crucial product differentiator for the ResMed N30i. The nasal cushion itself is also cleverly engineered with a supportive chassis on the outside that stabilizes it even during much tossing and turning. The chassis does have some plastic that may bother some side sleepers. The cushion's septum has a membrane bridge to seal out leaks while the thickness varies across the cushion. to protect delicate areas and provide stability against regions with more surface area.
The frame and the headgear from the AirFit N30i nasal mask are fully compatible with the nasal pillows in the AirFit P30i. The P30i pillow mask has the same discreet, minimalistic design as the N30i, using the same flexible silicone frame that delivers air flow from an over the head connection to the CPAP tubing. The P30i retains the auto-adjusting ribbing that keeps the frame snug but not too snug, no matter the sleeping position.
The P30i nasal pillows insert into the nostrils with a springy seal that delivers a comfortable, effective fit. Fitting pillows can be a bit tricky as you need them to sit just right. If they are too small, nasal irritation and high-velocity flow can cause users to give up. If they are too large, they often pop out. The AirFit P30i packs in all three available sizes of pillows so all three can be tried at home and the best size selected for the individual user.
The AirFit P30i is compatible with any home CPAP machine, but it is not compatible with ResMed's AirMini travel CPAP unit. ResMed sells a different pillow mask for the AirMini, somewhat confusingly called the AirFit P10 for AirMini.
- Minimal contact masks that keeps vision unobstructed
- Stretchable frame auto-adjusts the fit
- Side sleeping and active sleeping do not impede mask fit
- Trade out the under the nose cushion for nasal pillows or trade out nasal pillows for the under the nose cushion
- The N30i nasal mask has two size options for wider noses
- Silicone tubing touches the cheeks unless fabric sleeves are added
- Air flow through the frame bothers some users
- The N30i nasal cushion's exterior has some plastic componen
High-Performance Full-Face Masks in 2021
Like nasal masks, full face masks have evolved considerably. So much so, that describing them as "full face masks" is starting to seem inaccurate as all the top face masks to choose from in 2021 have designs that reduce the overall footprint on the face or the heft of the mask compared to models from just a few years ago.
Face masks are often preferable to nasal masks for CPAP users who breathe mostly through their mouths. Sleep apnea patients who need particularly high settings also often benefit from a face mask. Some people just like the fit and feel of a face mask better.
A traditional full face mask uses a triangular cushion that sits on the bridge of the nose and under the lower lip near the chin. Often a stabilizing bar extends from the frame to a forehead pad on the bridge of the nose. Modern face mask designs may or may not rely on a stabilizing bar or a forehead pad for forehead support. Some face masks use "over the mouth" cushions and leave most of the nose untouched, giving back visual space to face mask wearers.
The first full-face mask in this 2021 selection guide brings us back to the DreamWear line from Philips Respironics. The DreamWear Full uses an over the mouth / under the nose cushion instead of the traditional triangular cushion. The DreamWear Full also uses the same hollow silicone frame as the DreamWear Nasal and DreamWear Nasal Pillow masks. The CPAP tubing connects to an elbow connector at the crown of the head, and airflow travels through the frame to the face cushion. The over the head connection removes downward drag on the mask which is particularly beneficial for a larger cushion full face mask where the opportunity for leaks is increased due to the larger surface area.
The headgear clips to the cushion at different angles than the headgear that is used with other DreamWear cushions (nasal and pillows). The new DreamWear "headgear with arms" is not compatible with the DreamWear Full mask. Balancing the oral cushion necessitates a different headgear design altogether so the compatibility decisions by Philips Respironics make sense, even if they make things a bit confusing for the consumer.
The DreamWear Full Face mask owner can choose to swap in the DreamWear nasal cushion and the DreamWear nasal pillows but will need to pick up the Headgear with Arms to do so as well as the nasal cushions or pillows.
The headgear attaches to the face cushion with magnets, so getting hooked up each night is a snap. Anyone with a medical implant, though, should check with their medical provider before using anything magnetic.
The over the mouth cushion comes in four sizes, small, medium, large, and medium-wide. The frame comes in three sizes. Although lots of sizes create hesitation about what to select, the variety increases the odds of finding a combination that fits perfectly. Philips Respironics sells the DreamWear Full in some FitPack options that let the wearer determine the best combination with their machine and in their bed.
The DreamWear Full has a minimal footprint on the head and face. Vision is wholly unobstructed and side sleeping is reasonably possible. The DreamWear Full is an excellent option for CPAP or BIPAP users who are mouth breathers or who need higher pressures than some nasal masks can keep up with but who tend to feel claustrophobic or anxious in a more traditional full-face mask. Compatibility with nasal cushions and nasal pillows also gives options to users who find it helpful to use a face mask when they are sick or congested but who prefer a nasal mask at other times. Rotating mask types can also help prevent pressure injuries on the face by altering the points of pressure from time to time.
The F30 from ResMed offers full face CPAP users a quiet, lightweight fit with many of the advantages of a nasal cradle cushion or nasal pillow mask. The F30 is an ultra-compact face mask that uses an over the mouth cushion instead of a triangular cushion. An ovoid-shaped cushion sits low on the face, covering the entire mouth, resting on the upper lip under the nostrils and below the lower lip. Since the mask does not sit on the bridge of the nose, it does not leak into the eyes or contribute to pressure injuries on the nose bridge. Other than the mouth and nostrils, most of the face is left untouched so there are no obstructions to vision. Nothing prevents the user from wearing glasses, and claustrophobia is unlikely to be a concern.
The frame on the F30 itself is minimal, lending just enough plastic to hold the cushion and attach it to the headgear. The F30 frame does not have a stabilizing bar and neither the frame nor the headgear crosses the forehead.
The cushion is broad and flexible to accommodate a wide variety of facial shapes. The cushion only comes in two sizes, small and medium. Sizing is based on the horizontal width of the nose. The sizing guide included with the mask tends to suggest the smaller size a bit sooner than it probably should. If in doubt, try the medium. The over the mouth cushion does not block the nostrils, but rather it cradles them like the nasal cushion on the N30i or N30, so airflow does enter the mouth and the nose.
The cushion is held to the face via headgear that has five points of adjustment. Face masks are often tricky to fit since they cover so much surface area, but the angles of the straps on the F30 headgear along with a crown strap let the user position the cushion just right for their facial contours. The headgear attaches to the cushion with magnetic clips so getting hooked up is no chore. Anything with magnets, though, should be used only after consulting with a medical provider for anyone with any medical implants like a pacemaker or internal defibrillator.
- Quiet and lightweight
- Over the mouth / under the nose cushion
- Soft cushion and soft headgear
- Mouth breathers can wear the mask and still read and watch TV
- Magnetic clips attach headgear to the cushion (assuming no medical implant concerns)
- Handles high settings well
- Magnetic clips may be contraindicated for someone with medical implants
- Only two sizes of cushions, small and medium
- Sizing guide may lead people to believe they should use a small when they would be better off with a medium
Fisher and Paykel launched the Vitera in the Fall of 2019. The Vitera is a substantial update to Fisher & Paykel's much loved, Simplus mask. The Vitera is as quiet, if not quieter than the Simplus, and includes some nice upgrades to the frame, cushion, and headgear.
The Vitera uses a triangular-shaped cushion that sits at the bridge of the nose and rests below the lower lip near the cleft of the chin. Like the Simplus, the cushion rolls back and forth at the bridge of the nose to maintain a seal in that leak-prone spot. The facial cushion on the Vitera extends considerably farther than the Simplus cushion and is a bit deeper and narrower around the bridge of the nose. As a result, the Vitera accommodates a broader spectrum of face sizes and leaks less around the bridge of the nose and blows less air into the eyes.
The Vitera's frame is lighter than the Simplus frame, though it retains the stabilizing bar between the eyes. The stabilizing bar is a bit narrower, in any case. The headgear and frame lay flat across the forehead as they do on the Simplus, without a forehead pad.
At first glance, the headgear appears the most changed. It is a bit narrower than the headgear on the Simplus, yet it is still quite sturdy and will stand up to repeated cleaning. Also new to the headgear is a mesh compartment on the back that wicks heat and moisture away to keep the user cool and dry. The headgear clips are quite user-friendly on the Simplus, but the Vitera adds some tactile grips to make them even easier to grasp a firm hold.
The Vitera has quite a few parts and pieces to take apart and reassemble. Fisher & Paykel have added blue highlights to the components to guide assembly. Overall, the Vitera is a sturdy, stable full face mask, and it's the synergy between the frame, headgear, and cushion that makes it relatively easy to put on and get a solid fit night after night.
- Broad cushion fits most face sizes and shapes
- Lighter frame than many full face masks
- Rolling design at the nasal bridge auto-seals leaks near the eyes
- Breathable, moisture-wicking headgear
- Headgear has five points of attachment, including a crown strap to get the cushion height just right
- Stabilizing bar comes up between the eyes
- Many parts and pieces, though the blue highlights do help with assembly
- Difficult to wear glasses or read with the mask onm
The Simplus is an older mask that was released in early 2014, but like the ComfortGel Blue Nasal mask, it has a solid fan base for several compelling reasons and is far from being an obsolete choice for full face mask sleep therapy in 2021. The Simplus was one of the first face masks to reduce the girth of the headgear, lighten the frame, and remove the forehead pad. It is also exceptionally quiet which can be a concern with full face masks.
The frame on the Simplus does have a stabilizing bar that runs between the eyes to the forehead, so the field of vision is not entirely unobstructed, but at the forehead, the frame flattens out and there is no forehead pad. A rotating ball and socket joint allows the tubing to glide with the user and the mask, giving the wearer freedom of movement without jostling the mask out of position.
The Simplus has a lightweight, dual-wall cushion that seals best when the headgear is not tightened too much. Tight-fitting headgear will crimp the outer cushion layer and introduce gaps. The cushion rocks back and forth at the bridge of the nose to seal off leaks. Fisher & Paykel describe this as "RollFit technology," and it works quite well. At particularly high settings, though, especially for patients on high BiPAP settings, the high flows from the CPAP machine push the cushion out of position and the leak gets harder to maintain without additional headgear adjustments. The cushion is a bit slicker and smoother than some full-face cushions, so it slides on the face, moving with the user and reseating itself. The cushions on some full face masks are a bit sticky or tacky; with movement, they break away from the face instead of moving with it.
The headgear has stretch and non-stretch panels to customize the fit around the head and reduce slippage, while also allowing the headgear to "give" at the right times as well. A crown strap contributes a fifth point of adjustment that assists with positioning the cushion at the right height. The headgear attaches to the frame with ergonomically friendly hooks that clip on without the need for much finesse.
- Smooth cushion that rolls back and forth at the bridge of the nose to auto-adjust fit and minimize pressure injuries
- Five points of adjustment, including one at the crown strap to optimize mask height
- Sturdy headgear that retains its shape with stretchable and non-stretchable sections
- Lighter frame than many prior full face masks
- Somewhat higher leak rate especially at higher settings than some masks on the market
- Stabilizing bar on the frame may bother users who tend to get claustrophobic
- Difficult to wear glasses when in use