CPAP therapy provides a steady flow of pressurized air to keep the airway open during sleep, effectively treating obstructive sleep apnea. Selecting the correct mask is an important part of successful therapy. This decision becomes more complex when a person tends to breathe through their mouth while asleep, as mouth breathing can significantly compromise treatment effectiveness. The best solution for a mouth breather is a mask that covers both the nose and mouth, or a combination of accessories that secure the mouth shut.
Understanding CPAP Mouth Breathing Issues
Mouth breathing during CPAP therapy, especially when using a mask that only covers the nose, creates a “mouth leak.” The pressurized air meant to keep the upper airway open escapes through the open mouth. This leads to a reduction in the prescribed pressure reaching the airway, which significantly reduces the efficacy of the therapy and may cause a return of sleep apnea events.
Air leaking from the mouth commonly results in a very dry mouth and throat upon waking. This occurs because the continuous airflow bypasses the natural humidification process of the nose and evaporates moisture. Furthermore, a large leak can cause a noisy rush of air, potentially waking the user or their partner. Addressing this issue is necessary for comfortable and effective therapy.
Full Face Masks
The most direct solution for a CPAP user who breathes through their mouth is the full face mask. This mask style forms a seal that covers both the nose and the mouth. It ensures that pressurized air remains contained within the system regardless of whether the user breathes nasally or orally, preventing pressure loss and dry mouth associated with mouth leaks.
Modern full face masks are available in various styles, moving beyond the traditional bulky design. Some contemporary models feature a cushion that fits under the nose rather than over the bridge, offering a less obstructive field of vision. This under-the-nose design can reduce irritation and red marks that sometimes occur near the bridge of the nose.
Mask cushions are primarily made from silicone, which offers a reliable seal. Newer options also include foam cushions that conform gently to facial contours for increased comfort. Many full face masks incorporate quick-release features, such as magnetic clips, allowing the user to easily put on or take off the mask without readjusting the headgear straps. This security makes the full face mask an effective choice, especially for those requiring higher air pressure settings.
Hybrid Masks and Chin Straps
Hybrid masks offer a smaller footprint while still managing mouth breathing for individuals who find traditional full face masks too extensive. Hybrid designs typically use nasal pillows or a small nasal cradle to seal the nose, coupled with a separate cushion sealing around the mouth. These masks are less bulky than standard full face masks and often appeal to users who feel claustrophobic or prefer an open line of sight.
A chin strap can be used in combination with a standard nasal mask or nasal pillow mask. This fabric accessory wraps around the head and gently supports the lower jaw, physically keeping the mouth closed during sleep. This encourages nasal breathing and prevents air from escaping through the mouth, maintaining the prescribed pressure within the system.
While a chin strap is a low-profile and inexpensive accessory, some users may find it restrictive or uncomfortable. A chin strap alone does not treat sleep apnea and must be used with a positive airway pressure device to be effective. The combination of a nasal mask and chin strap is often a preferred solution for users who want minimal facial contact but need help preventing their mouth from opening.
Achieving the Best Mask Seal and Fit
An accurate fit is necessary to ensure the effectiveness of CPAP therapy, regardless of the mask style chosen. An improperly sized mask can lead to air leaks, discomfort, and skin irritation, compromising the entire treatment. Manufacturers provide sizing guides, often involving measurements of the nose width and the vertical distance from the nose bridge to the chin, to help users select the correct cushion size.
When adjusting the mask, users often overtighten the headgear straps in an attempt to stop air leaks. Overtightening can distort the cushion and actually cause new leaks, in addition to creating painful pressure marks. The straps should only be tightened enough to achieve a seal without causing excessive pressure. A good test is to try on the mask with the machine running while lying down, as this position mimics how the face changes during sleep.
Routine cleaning and replacement of mask components, such as the cushion and headgear, are necessary for maintaining a secure seal. Materials like silicone or gel naturally degrade over time, and a worn cushion will not hold a seal effectively. Considering factors like facial hair, which can interfere with the cushion seal, and selecting a comfortable mask material are also important steps in optimizing the fit and ensuring consistent therapy.