CPAP interfaces that cover both the mouth and nose are becoming lighter and more comfortable.
Big and bulky: two of the last words anyone wants to hear when in search for the perfect CPAP full-face mask. Patients suffering from obstructive sleep apnea (OSA) have enough to adapt to as it is, so manufacturers’ path for developing a light and comfortable interface has been a crucial one.
Full-face masks are typically the best option for mouth breathers and for patients who are congested from allergies or colds. But patients sometimes hesitate because of the interface’s size, especially in relation to the typically smaller nasal and nasal pillow masks.
That’s why CPAP interface providers and technologists pride themselves on the advancements made in recent years with mask materials and design. Sleep techs have recently seen great progress with full-face sleep masks and have noticed a few trends along the way.
Today, it’s becoming the norm that patients can wear their masks comfortably while reading or watching TV right before bed. Generally speaking, gone are the days of residual respiratory events, arousals, and leaks, which were more common with older full-face mask designs. New masks are designed to be more comfortable and easy to put on and take off, says Philips’ chief medical liaison Teofilo Lee-Chiong, MD. “We will continue to see smaller and lighter options that cover less of patients’ faces, minimizing discomfort and allowing the person to be more active while wearing their mask,” Lee-Chiong says. Philips Respironics is already touching on these advancements with its Amara View mask, which was released last year.
Because newer masks are more comfortable and durable, Lee-Chiong adds, “It is important to discuss new mask offerings with patients who are being prescribed CPAP treatment for the first time, as well as those who are long-time users of the therapy.”
There are other game changers in the field too. Fisher & Paykel Healthcare (F&P) believes its RollFit Seal to be among them. Its patented RollFit design, which can be found on its Simplus full-face and Eson nasal masks, has a one-piece seal that “rolls” back and forth on the bridge of the nose to adjust automatically. The technology was designed to minimize pressure on the bridge of the nose. “It is an easy auto-adjusting fit that optimizes an effective, comfortable seal that promotes the mask to be in tune with the patient,” says Robin Randolph, OSA marketing manager with F&P.
Being the right fit for a patient is always key for any mask, of course. That’s why Circadiance offers a 30-day money back guarantee on its SleepWeaver mask—so patients are able to rest easy about their purchase, so to speak.
Circadiance’s sales and marketing vice president Jim Seles predicts that in the coming years, the major emphasis will continue to be on improving fit and seal while not compromising on comfort. “Maintaining field of vision will remain important, but not as important as overall fit, seal, and comfort,” he says. One of the biggest innovations in recent years, Seles believes, has been the soft cloth CPAP mask construction. “Since its entry into the market in 2008, [it] has offered several advantages for full-face mask wearers, particularly those who are side sleepers,” he says.
Another draw for patients is when sleep mask providers can offer support tools for patients so patients can be confident they were sized correctly in their initial setup. For example, ResMed Mask Tips and myAir platforms are two tools that provide patients with coaching “in the critical early stages of the therapy journey.” A retrospective study of myAir data found that use of the platform was associated with high adherence in these crucial beginning stages, the company reported—with 84% of new CPAP users achieving Medicare adherence guidelines in the first 90 days and 75% in the first 30 days.
The process, of course, might not ever be flawless. But “the benefits patients receive from their therapy will far outweigh any of the initial struggles or frustrations,” says ResMed’s Rowan Ellis, senior manager of patient interface. “We’ve come a long way in making masks more comfortable, smaller, and lighter, but there’s always room for improvement.”
Much of the advancement for full-face masks is sitting well with many patients, but a lighter mask isn’t the fix for every user.
According to Hans Rudolph president Kelly Rudolph, “Everyone thinks having less on their face is better for claustrophobia,” but that isn’t the case for every individual. “Once a patient is getting a good night’s sleep without waking up due to leaks and other problems that occur with using only a nasal mask or nares type interface, they learn to love their full-face mask,” he says.
Rudolph says that it is easier to achieve a solid seal with a full-face mask—“especially [with] the Hans Rudolph mask because there is no hard frame so the soft face piece with a chin cup attaches to the face and seals easier,” which he says is helpful regardless of whether the patient is a nose or mouth breather.
And a lot of work has gone into improving the seals. Material selections have grown wider and formulations have improved, Rudolph says. “We have implemented softer face sealing materials, used stereolithography/3-D printing to develop improved geometries for better comfort and seal, and with the trend to make lighter masks, we have engineered wall sections and new materials and designs to be lighter,” he says, adding that “improved headgear optional materials have helped us to make more comfortable and effective headgears.” Several masks, such as Hans Rudolph’s V2 full-face mask, even allow eyeglasses to be worn.
After all of the innovation that has taken place with full-face masks, the response from patients has improved in recent years as masks better adjust to wearers’ comfort. For some, like with Hans Rudolph, OSA patients reach out with feedback, which Rudolph says has been overwhelmingly positive. “We can’t believe they actually take the time to contact us,” Rudolph says. “Their expressions are like they have received an early birthday gift.”
Stephanie Forshee is a New York-based journalist. She writes for a variety of business-to-business magazines.