A mask that does not fit well is one of the most common reasons people struggle with CPAP, and it is often fixable. Before you decide CPAP is not for you, work through the checks below. Many noise, leak, and comfort problems come down to a small adjustment, a worn part, or a mask that is not the right style or size.

Start with a two-minute check

  • Seat the mask with the air on. Put the mask on, turn the machine on, and lie down in your usual sleep position. Then adjust. A mask can feel fine sitting up and leak the moment you lie down.
  • Do not overtighten. Too tight can distort the cushion and cause leaks and sore spots. Snug is enough.
  • Check the connections. Make sure the tubing, elbow or swivel, and headgear clips are all seated.
  • Look at the tubing. Small cracks or holes cause hissing.
  • Keep the vent holes clear. The small holes on the mask are meant to let air out. A soft airflow sound there is normal. Do not block them.
  • Check the cushion. Cushions wear out, and skin oils break them down. A stretched, stiff, or dirty cushion is a very common cause of whistling and leaks.

If the mask is noisy

  • Whistling or hissing at the edge of the cushion usually means air is leaking out where the mask meets your face. Re-seat it, check the cushion, and ask us about fit.
  • A flapping or vibrating sound often means a poor seal or a worn cushion.
  • Gurgling or water in the tube is usually condensation. A tubing cover or lower humidity setting can help. Ask us about options for your machine.
  • A rattle may be a loose part.
  • A louder machine can be a dirty filter. Check it against your cleaning instructions.

If the mask leaks

  • Leaks from your mouth with a nasal mask or nasal pillows can mean your mouth opens in your sleep. A different mask style or a chinstrap may help. Ask us.
  • Leaks when you roll over can come from tubing pulling on the mask. Some mask designs route the tubing over the head instead of in front of you, which some side sleepers find easier.
  • Air blowing toward your eyes is a fit problem. Do not ignore it, since it can dry and irritate your eyes.
  • Facial hair can break a seal. Mention it when you are fitted.

If the mask is uncomfortable

  • Red marks or sores on the bridge of your nose usually mean the mask is too tight, the wrong size, or the wrong style for you.
  • Feeling claustrophobic is common. Practice wearing the mask while awake, and ask about smaller styles that sit under or around the nose.
  • Straps leaving deep marks often mean the headgear needs adjusting or replacing.

The right mask depends on you

Masks come in several styles, such as full face, nasal, and nasal pillows, and in different sizes. The best one depends on how you breathe, how you sleep, and the shape of your face. If your first mask is not working, that is not a sign you did anything wrong. It may just not be the right one for you. We fit masks from ResMed, Philips, Fisher & Paykel, and other brands, so we can look for the one that suits you.

Do not forget replacements

Cushions, headgear, and tubing wear out, and fresh parts often fix problems on their own. Insurance usually covers replacements on a schedule, which varies by item and plan. In practice, most patients can get an entire new mask about every six months, with cushions replaced more often. See our supply replacement guide on the FAQ page, or ask us what you are eligible for.

Bring it in

Call us at 800-442-6704 and we will schedule you with one of our PAP specialists at our La Grange or Bastrop office. Bring your mask and machine, and the specialist can look at the fit and talk through your options. Changes to your pressure setting must come from your doctor. If you have a detailed prescription for a pressure change, bring it to any of our offices.

This article is general information, not medical advice. Always follow your doctor’s instructions for your therapy.