Why Does my CPAP Mask leak? How to stop CPAP Mask from leaking

Nasal Masks and Interface Problems Addressed

Question:

Why does my mask leak? Whenever it leaks and I pull it down to make it tight, it always leaves red marks on my face and the bridge of my nose starts to hurt. Am I doing it right?

Answer:

In order to avoid leakage and adjust the mask to your comfort level, first of all you need to know more about the nasal mask. There are 5 CPAP interfaces i.e. nasal masks, full face mask, nasal pillow, nasal oral masks and oral masks. Take a look at these masks one by one to know more about their fitting. After this you will get to know how to Stop CPAP Mask from leaking.

Nasal Masks

This is the mask that can fit over the nose of the user only. Most of these masks have a rigid clear plastic frame with a silicon rubber cushion for fitting against the face. It has forehead support too. You will find such masks too that do not have any kind of forehead support. Example can be SleepNet's Mini Me™, IQ™ and Phantom™ . There are such nasal masks available too that have a silicone gel material in the cushion that can help in equalizing the pressure against the face of the user. Example of such masks include ProfileLite™ , ComfortGel™ , ComfortGel Blue™ , and the Comfort TrueBlue™ from Philips Respironics ™, ResMed's Mirage™ SoftGel and the ones mentioned prior to these.

A bubble style cushion technology was developed by SULLIVAN™ in the mid-90s. The company today is known with the name ResMed™. This technology was further improved by ResMed and Philips Respironics in the Mirage™ FX and ComfortFusion�. These masks are designed in such a way that they offer better seal and comfort to the user without putting much pressure on the face.

Rules for using the nasal mask:

Tighten the bottom straps of the masks firmly and keep the top straps loose. Hold up the mask in its position.
Connect the CPAP machine to the nasal mask and turn it on.
Now lay down so that final adjustments could be made.
Keep this thing in mind that gravity always exerts downward pull no matter what position you are in.

These are simple rules of thumb. Each CPAP mask has its own specifications. Facial features of each individual are different too. So you will have to find that mask that fits your facial features to a certain level.

Final adjustments:

So when the mask in place and the CPAP machine is running and you are lying on the bed, you can start with the final adjustments.

If the mask has an adjustable forehead support, then start with adjusting it. This will reduce the escape of the air pressure. If you will go to the next adjustment then your mask will start to leak. It is better to Stop CPAP Mask Leaks. You need to find such a place where the mask does not leak and the pressure of the mask does not cause soreness. This adjust will work for the bubble mask only.

A bubble mask is specially designed for using the air pressure created by the CPAP machine, pushing it against the silicon rubber and hence creating a seal. A tight strap pressure means that your silicone rubber will turn inside out and the mask will start to leak. If you will tight it further then this will just make the mask worse.

Full Face Masks:

A full face CPAP mask is meant to cover the nose as well as mouth. These masks seal under the bottom lip. The mask will leak when the bottom jaw drops. This usually happens when the person is sleeping. There are such full face masks available too that come with a chin support feature. Fisher & Paykel™ HC431A and Hans Rudolph™V2 are such masks. The chin support is designed to hold the lower jaw so that the bottom seal can be kept intact.

ResMed Mirage Quattro™ is a mask that has a seal at the cleft of the chin. The seal will still be in its position even if the lower jaw drops during sleep.

The same thumb rules also apply here which have been outlined for the nasal masks.

Nasal Pillows:

These are the small silicone rubber cushions that are adjusted into the nostrils. They seal against the outer edge of the opening of the nostrils. They are oval in shape and they are made from special silicone rubber compound. They have the shape of the nostril opening so adjusting them will not be a problem. Initially they were developed by Puritan Bennett T. Now a number of companies have come up with their own versions of nasal pillows.

ResMed has made Swift™, Swift™, Swift LT™, Swift FX™, and Swift FX™ for females. Philips Respironics™ has the ComfortLite™, and the GoLife™ for Men. It has also produced GoLife™ for females, and the OptiLife™ and OptiLife™ II too. The Adams Circuit Nasal Pillows™ by Puritan Bennett were the original nasal pillow system. Now that technology has come with many innovations, the Bravo and EVO Medical Solutions have been developed that distribute the CPV3 nasal pillow system.

Fitting the nasal pillows:

CPAP Mask Leaking can be prevented if you fit the mask according to the following procedure.

The pillow cushion opening must be smaller than the opening of the nostril to a slight level. Almost 90 percent of the CPAP users use the large size pillows
The pillow must be extended into the opening of the nostril by 1/8" to 3/16"
Pillows are mostly oval shaped. The side with long axis should align with the long axis of the opening of the nostril.( Exception:Tthe angle of the pillows for ResMed's Swift nasal pillow systems and Philips Respironics™ ComfortLite OptiLife, and GoLife nasal pillow systems are fixed, they cannot be adjusted. They are made from silicone rubber compound which can easily adapt the shape as well as the angle of the nostril.)
The headgear tension must be sufficient for setting the seal. Do not pull the pillows up into the nostril too tightly otherwise it may cause nose distortion.

Oral Nasal Masks:

An oral nasal mask is the one which covers the mouth with silicone rubber mask. The rubber mask has nasal pillows extended on the top. They go straight into the nostril opening. Innomed Technologies produces oral nasal masks called the Hybrid 500 and ResMed produces the Mirage Liberty™

These are designed for such individuals who need a full face mask but cannot tolerate wearing one. These masks are difficult to adjust. You have to hold it place making sure it does not move. The pillow also needs adjustment. They are fitted into the opening of the nostril just like it�s done in a regular nasal pillow. The vertical adjustment of the nasal pillows can only be made to 2 distances. So placing the oral mask will be much critical. It might also be difficult to Stop CPAP Mask Leak in this case.

Oral Masks:

The oracle by Fisher and Paykel is the only oral mask available. You have to choose the correct sized seal that fits between the teeth and lips easily. You can either choose a large sized seal or a small one. Once you have selected the seal and placed it on the system, you will have to adjust the outer seal around the lips. Tightening it will be easy as the adjustment is similar to a screw. The CPAP Mask Leak will hence be adjusted with ease. You need to be careful that you don�t pinch your lips while tightening the inner seal.