In short
- The four main CPAP mask types are nasal pillows, nasal masks, full face masks and hybrid masks, which seal over the mouth and under the nostrils.
- A 2020 American Thoracic Society workshop report concluded that a nasal mask should be the first option for most people with obstructive sleep apnea, even though mouth breathing is common.
- A 2018 meta-analysis of 13 trials and 4,563 patients found full face masks were linked to about 1.5 cm H2O higher pressure, 2.8 more residual events per hour and 48 fewer minutes of use per night than nasal masks.
- In a 2019 crossover trial of 85 people, about a quarter (25.9%) used CPAP most with a full face mask, so the best mask still varies from person to person.
- In a small 2003 trial, nasal pillows were used on more nights than a nasal mask and caused fewer side effects and less air leak in the first weeks of CPAP.
- A good fit is snug but not tight. Stanford Health Care says most leaks can be fixed by pulling the mask away from the face and reseating it.
There are four main types of CPAP mask: nasal pillows, nasal masks, full face masks and hybrid masks. A 2020 American Thoracic Society report recommends starting most people on a nasal mask, and research links nasal masks to lower pressures and longer nightly use than full face masks. But the right mask is the one you'll actually wear all night, and some people try a few before finding the one they like.
What are the main types of CPAP mask?
The main types of CPAP mask differ in how much of your face they cover and whether they send air through your nose, your mouth or both. Cleveland Clinic describes four types:
- A nasal mask covers your nose. Providers often recommend it if you move around a lot during sleep.
- A nasal pillow mask covers only the nostril area, and some styles have prongs that sit in the nostrils. People can wear glasses comfortably with it.
- A full face mask is a triangular mask over the nose and mouth. Cleveland Clinic says it's best if you breathe through your mouth during sleep, and may be recommended if you have a nasal blockage.
- A hybrid mask is a type of full face mask that fits over the mouth, with prongs or cushions sealing the nostrils, without covering the bridge of the nose.
A 2020 American Thoracic Society (ATS) workshop report also lists cradle masks and low-profile full face designs. It says manufacturers designed these variations to tackle different complaints and offer comfort, sealing and stability.
Which CPAP mask type suits you?
The best CPAP mask type depends on how you breathe, how you sleep, and what you can tolerate. This table sums up the four types.
| Mask type | What it covers | Often suits | Things to know |
|---|---|---|---|
| Nasal pillows | Nostril openings only | People who feel closed in by a mask, glasses wearers | Fewer side effects than a nasal mask in one small trial; can leak if the mouth opens |
| Nasal mask | The whole nose | Most new users, restless sleepers | First option for most people, according to the ATS report |
| Full face mask | Nose and mouth | People who breathe through the mouth or have a blocked nose | Linked to higher pressures and shorter use on average |
| Hybrid mask | Mouth, with a seal under the nostrils | People who need mouth coverage | No studies we could find comparing it with other types |
Your sleep team will help you choose, and NHLBI says your provider will work with you to find the most comfortable mask that works best for you. Cleveland Clinic adds that some people try a few different masks before finding the one they like best.
Are nasal masks better than full face masks?
Research: moderate (what this means)Nasal masks do better than full face masks on average, according to the research, but plenty of people do well on full face masks. We rate the evidence as moderate: it includes a meta-analysis and randomized trials, but most trials are small and short.
The strongest evidence is a 2018 meta-analysis in Chest that pooled five randomized and eight nonrandomized trials with 4,563 patients. Compared with nasal masks, full face (oronasal) masks were linked to:
- A higher CPAP pressure, by about 1.5 cm H2O on average
- More breathing events left over during treatment, about 2.8 more per hour
- Poorer use, about 48 minutes less per night
The ATS workshop report reached a similar conclusion. Its main finding was that nasal CPAP should be the initial option for most patients. It explains that a full face mask may make the airway more likely to narrow, which can lead to high leak, leftover breathing events and higher pressure needs. It also notes that swallowing air (aerophagia) is more common with full face masks.
The averages don't apply to everyone, though. In a 2019 randomized crossover trial in Respirology, 85 people with moderate to severe sleep apnea tried a nasal mask, nasal pillows and a full face mask in turn. Nightly use was highest with the nasal mask (3.96 hours) compared with the full face mask (3.26 hours) and nasal pillows (3.48 hours). Leftover events were higher with the full face mask. But 25.9% of people used CPAP most with the full face mask. Those people tended to have less nasal blockage and particular facial proportions.
Nasal pillows or a nasal mask?
Nasal pillows and nasal masks both send air through the nose, and both are reasonable first choices. The research comparing them is limited and points in slightly different directions.
In a 2003 randomized crossover trial in Chest, 39 people new to CPAP used nasal pillows and a nasal mask for three weeks each. They used CPAP on more days with pillows (94.1% of days vs 85.7%), though minutes per night weren't significantly different. With pillows, they reported fewer side effects, less trouble getting to sleep and staying asleep, and less air leak. Pressures in that trial went up to 14 cm H2O, and the authors said longer studies were needed.
In the 2019 trial, the nasal mask came out slightly ahead of pillows for nightly use, while leftover events were about the same with both.
Pillows can be a good option if you feel claustrophobic. Stanford Health Care says changing styles can help with feelings of claustrophobia, suggesting a switch to nasal pillows or, though it sounds counterintuitive, a mask that covers both nose and mouth.
What CPAP mask is best if you breathe through your mouth?
If you breathe through your mouth, a full face mask is the obvious choice, but it isn't always the first step. The ATS report says that although mouth breathing is common among people with sleep apnea, a nasal mask is usually the best option for most patients.
Mouth leak on a nasal mask happens in two main ways, according to the ATS report. The jaw can drop open, or the soft palate can sag back when you breathe out, blocking the nose so air escapes through closed lips. Risk factors include nasal blockage, older age, obesity and male sex. The report lists ways to manage it:
- Checking the mask seal
- Treating a blocked nose
- Heated humidification, which can ease congestion and help the mouth stay sealed
- A chin strap, though the report notes chin straps aren't comfortable enough to wear long term and may increase airway resistance in some people
If mouth leak is still a significant complaint after those steps, the report says a full face mask can be considered. It also advises close monitoring when switching from a nasal to a full face mask, because the pressure may need adjusting.
One useful detail: the ATS report says fitters should watch for mouth breathing rather than just ask about it, because many people breathe through their mouth at night as they catch their breath after apneas. Our guide to dry mouth with CPAP covers mouth leak in more depth, and a blocked nose has its own fixes in deviated septum and sleep apnea.
How should a CPAP mask fit?
A CPAP mask should fit snugly enough to seal but not so tightly that it digs in. Stanford Health Care's fitting tips say the mask should be snug, but not so tight that it feels glued to your face. There should be some give so it shifts with you during the night and keeps its seal. For most nasal masks, there should be enough slack to pull the mask about an inch away from your skin.
Stanford's tips for common problems:
- Most leaks can be fixed by pulling the mask away from your face and reseating it.
- If a nasal mask leaks, the strap diagonally opposite the leak is often too tight, or the strap closest to it too loose. Try to get the strap tension equal.
- For claustrophobia, hold the mask in place with your hand for a few minutes before putting on the headgear.
- Heated humidification can reduce dryness and congestion, which helps limit mouth breathing. Set too high, it can cause excess condensation, sometimes called rainout.
Cleveland Clinic notes that masks can cause skin irritation or redness, and that the right size and padding can reduce this. The ATS report says CPAP habits are established within the first week of therapy. It also recommends involving your partner in choosing a mask, and expecting that it may take more than one try to find the right one.
Keeping the mask clean matters too. NHLBI says to clean your mask and tube every day and replace them on schedule. Our guide to CPAP cleaning and supplies has the details, and getting used to CPAP covers the first few weeks.
When should you call your sleep team?
Call your sleep team if your mask leaks, hurts, leaves sores, or keeps coming off at night despite adjustments. Leaks and discomfort are fixable, and the ATS report stresses that early troubleshooting matters most in the first week. NHLBI says to stop using your CPAP and call your provider right away if you have stomach discomfort or bloating.
Also call if you still snore or feel sleepy on CPAP. The ATS report recommends regular checks of leftover breathing events, leak and use, combined with how you feel. Our guide to snoring with CPAP explains the common causes. If you develop a blocked nose that won't clear, or you become pregnant, check in with your clinician, since both can change what you need. This article is general information, not medical advice.
Read next
Common questions
What are the different types of CPAP masks?
There are four main types. Nasal pillows sit at the nostrils, nasal masks cover the nose, full face masks cover the nose and mouth, and hybrid masks cover the mouth with cushions or prongs sealing the nostrils, without covering the bridge of the nose. Cleveland Clinic notes that some people try a few masks before finding the one they like best.
Which CPAP mask is best?
There's no single best mask. A 2020 American Thoracic Society workshop report concluded that a nasal mask should be the first option for most people, and a 2018 meta-analysis found nasal masks were linked to lower pressures and longer nightly use than full face masks. But in a 2019 trial about a quarter of people did best with a full face mask.
What CPAP mask is best for mouth breathers?
A full face mask is the usual answer, but not always the first step. The American Thoracic Society report says that although mouth breathing is common in sleep apnea, a nasal mask is usually the best option for most people. Fixing a blocked nose, heated humidification and a better seal can reduce mouth leak. A full face mask can be considered if leak remains a significant problem.
Are nasal pillows better than a nasal mask?
They suit some people better. In a 2003 trial of 39 new CPAP users, nasal pillows were used on more days and caused fewer side effects and less air leak than a nasal mask over three weeks. In a 2019 trial of 85 people, nasal masks had slightly higher nightly use than pillows. Pillows are often tried by people who feel closed in by a mask.
How tight should a CPAP mask be?
Snug, but not so tight it feels glued to your face. Stanford Health Care says there should be some give so the mask moves with you during the night, and that for most nasal masks you should be able to pull the mask about an inch away from your skin.
What is a hybrid CPAP mask?
A hybrid mask is a type of full face mask. Cleveland Clinic describes it as fitting over your mouth with prongs or cushions that seal your nostrils, without covering the bridge of your nose. We couldn't find research comparing hybrid masks with other types.
Sources
- CPAP machine
- The importance of mask selection on continuous positive airway pressure outcomes for obstructive sleep apnea: an official American Thoracic Society workshop report
- Nasal vs oronasal CPAP for OSA treatment: a meta-analysis
- Clinical outcomes related to interface type in patients with obstructive sleep apnea/hypopnea syndrome who are using continuous positive airway pressure
- Choosing the right mask for your Asian patient with sleep apnoea: a randomized, crossover trial of CPAP interfaces
- Mask fitting tips for PAP therapy
- CPAP
About this article
- Research
- 7 published sources, listed above.
- Evidence
- Moderate. How we rate it
- Last checked
- November 1, 2026
- Funding
- Paid partner of Titan Recovery. Their ads are labeled.
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* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.