What Are The Differences Between Nasal, Nasal Pillows, and Full Face CPAP Masks?

By: David Repasky · Published September 27, 2018
What Are The Differences Between Nasal, Nasal Pillows, and Full Face CPAP Masks?

David Repasky - CPAP Advocate & Specialist

Written and edited by David Repasky. David is a CPAP Patient Advocate and Equipment Specialist who brings a unique and vital perspective to the field of sleep apnea treatment. Since his own sleep apnea diagnosis in 2017, David has been on a personal journey that has transformed into a mission to help others navigate the challenges of CPAP therapy. His firsthand experience as a CPAP user, combined with his extensive knowledge of equipment and therapy practices, allows David to offer invaluable insights and support to those embarking on their own sleep apnea treatment paths.

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Finding the perfect CPAP mask suited for your sleeping habits and lifestyle is one of the most critical steps to maintaining CPAP compliance and experiencing a comfortable night's sleep while using a CPAP device.

In this article, we will cover the key differences between the three most common mask styles - Nasal Pillows, Nasal Masks, and Full Face Masks. We'll discuss the key factors to consider, such as your preferred sleeping position, whether you have facial hair, and your comfort level. By understanding these differences, you can make an informed decision when choosing the best CPAP mask for your needs.

Let's get started!

The Key Differences Between a Nasal Mask vs Nasal Pillow vs Full Face Mask

  • Nasal Pillow Mask: Nasal pillows tend to be the most compact of all three main types of CPAP masks. They are a very popular choice among those who do not require higher pressure from their CPAP machine. They are smaller and more targeted than the full face mask design. However, the most significant difference between nasal pillows and a nasal mask is that these masks seal into the nose via two soft pillows that insert directly into the nostrils rather than fitting around the nose.
  • Nasal Mask: Nasal masks are often described as having the smaller size of a nasal pillow, with a design that is similar to a full face mask. For this reason, these CPAP masks are a great option for those who are just starting their CPAP journey. Like the nasal pillow masks, these should be avoided by mouth breathers who have chronic sinus congestion or a deviated septum.
  • Full Face Mask: Despite not being the first choice among most people with CPAP machines, full face masks are still a necessity for a select group of individuals. Traditional designs allow for breathing through both the nose and mouth and are, therefore, a good option for individuals who cannot help but breathe through their mouths while sleeping. Unlike both the nasal mask and the nasal pillows, these CPAP masks tend to feel quite bulky and are not suited for people who toss and turn at night or like to sleep on their side.

What is a Nasal Pillow Mask?

Nasal pillow masks are usually the smallest of the three main types of CPAP masks and are generally the preferred choice for people who have Obstructive Sleep Apnea and struggle to sleep while having bulkier CPAP gear attached to their face. They are designed to sit directly under the nose, held in place by two flexible pillows that insert into each nostril.

Just like a nasal mask and a full face mask, these require some form of headgear to ensure they stay secure throughout the night. However, they have fewer straps and cover a much smaller part of the face compared to either of those masks. One of our favorites is the ResMed AirFit P10 Nasal Pillow CPAP Mask, thanks to the single strap design that leaves most of your face uncovered.

These masks tend to be more secure than many other styles thanks to the nasal pillow design and compact size. This allows people to have a bit more flexibility when it comes to sleeping positions and movements during sleep.

That said, these nasal pillow masks do have some limitations, particularly when it comes to individuals who need higher air pressure settings. Because airflow is directed straight up into the nostrils, higher pressure settings may cause more nasal discomfort compared to other CPAP masks.

What Are the Advantages of a Nasal Pillow Mask?

Nasal pillow masks are becoming much more popular in recent years. Let’s go over some of their advantages!

  • They are the least bulky of all the main types of CPAP masks.
  • They are often the preferred choice for people who struggle with claustrophobia.
  • They are better for side sleepers and stomach sleepers.
  • They are more likely to stay in place if you toss and turn at night.
  • They can be paired with a chin strap to prevent mouth breathing.
  • They can be worn while wearing glasses, watching TV, or reading.
  • They are less likely to cause skin irritation on the face.
  • They allow for a more secure fit on people who have facial hair.
  • They are less likely to have air leaks thanks to the nasal pillow design.

What Are the Disadvantages of a Nasal Pillow Mask?

While these masks have numerous benefits, nasal pillows do have a few disadvantages.

  • They may be uncomfortable for those whose CPAP machines are set to higher pressure settings.
  • They can cause nasal dryness, irritation, and nosebleeds.
  • They should not be used by people who have chronic sinus congestion or a deviated septum.
  • They are not suitable for those who regularly breathe through their mouth.
  • They do not allow you to switch to mouth breathing when you are sick or have allergies.
  • They may lose their seal if you breathe heavily through your mouth.

Related Article: Best Nasal Pillow CPAP Masks

What is a Nasal Mask?

Sometimes described as a nasal cup mask, a traditional nasal mask usually looks and works similarly to a full face mask, but instead of fitting from nose to chin, these cover the nose only. These CPAP masks have been typically made up of a plastic triangle-shaped cup with a silicone cushion, which seals around the nose on all sides.

Some newer versions, like the DreamWear Nasal CPAP Mask, act as more of a nasal cradle, covering the nostrils, rather than the entire nose. Like most other types of CPAP masks, the nasal mask is held in place with adjustable straps.

Nasal masks tend to be the first choice for those who have Obstructive Sleep Apnea and are new to continuous positive airway pressure therapy because they offer “the best of both worlds,” when it comes to CPAP masks. They are often considered to be the middle-ground option between a nasal pillow mask and a full face mask.

Their design includes the benefits of the smaller, more targeted style of a nasal pillow, without actually having something inserted into your nostrils. However, most types of nasal masks include headgear that is more similar to what you would wear with a full face mask.

Traditional nasal masks are also designed to withstand higher pressure settings compared to a nasal pillow mask. Therefore, they are a good option for those who have struggled to adjust to having pressurized air flowing directly into their mouth via a full face mask.

What Are the Advantages of a Nasal Mask?

Here are some of the reasons why nasal masks are such a popular option for nose breathers with sleep apnea!

  • They are less bulky than a full face mask.
  • They are better for people who feel claustrophobic when wearing full face mask.
  • They provide a more secure fit due to covering a smaller area than the full face mask.
  • They are better for side sleepers than full face masks.
  • They have a lower likelihood of causing nasal irritation than nasal pillows.
  • They allow for air pressure settings that are too high for a nasal pillow mask.
  • They can be paired with a chin strap to hold your mouth closed.
  • There are many style options to fit your face and nose shape.

What Are the Disadvantages of a Nasal Mask?

Despite their many benefits, sleeping with a nasal mask does have some downsides.

  • They may cause nasal discomfort (though not as much as a nasal pillow).
  • They should not be used by people who have chronic sinus congestion or a deviated septum.
  • They are not suitable for those who regularly breathe through their mouth.
  • They may be difficult to sleep with when you get sick or have seasonal allergies.
  • They can lose their seal if you move your upper lip too much.
  • Traditional nasal masks may not seal properly if you have a thick mustache.
  • They are usually larger than a nasal pillow.
  • The traditional styles often require more straps compared to a nasal pillow.
  • A traditional nasal mask may cause skin irritation along the cheeks or bridge of the nose.
  • They may leak more than a nasal pillow.

Related Article: Best Nasal CPAP Masks

What is a Full Face Mask?

While the name may bring about images of a hockey-style mask that covers your entire face, these masks are sometimes labeled oronasal masks, because they specifically fit over the mouth and nose, rather than the entire face. That said, the first and most obvious difference is that they do cover a larger portion of the face compared to the nasal CPAP masks that we’ve gone over.

These masks are usually held in place using straps that are similar to those found on traditional nasal masks. However, due to the additional bulkiness, they are less popular among sleep apnea patients and sleep specialists alike.

In fact, most sleep apnea experts suggest starting out with a nasal pillow, then trying a nasal mask, before moving to a full face mask only if necessary. This is because many people have a harder time acclimating to sleeping with a mask and headgear that covers so much of the face. This added size also tends to increase the likelihood of air leaks arising between the skin and the mask cushion.

Despite this, full face masks do have their place when it comes to treating sleep apnea via CPAP therapy. They are an important option for mouth breathers, or people who struggle to breathe solely through their nose while asleep. They also are also often recommended for those who require higher pressure settings during their CPAP therapy.

Of course, newer designs have become a bit more flexible, with the ResMed AirFit F30 being one of our top picks for side sleepers who prefer full face masks.

What Are the Advantages of a Full Face Mask?

While they may not be suitable for everyone, there are certain benefits to full face masks.

  • They allow you to breathe through your mouth and nose.
  • They can be used regardless of whether you experience sinus congestion.
  • They are less likely to cause nasal irritation compared to nasal CPAP masks.
  • They allow for air pressure settings that are too high for nasal pillows and nasal masks.
  • They are suitable for people who sleep on their backs.

What Are the Disadvantages of a Full Face Mask?

Here are some reasons why your sleep specialist may suggest going with a nasal CPAP mask, rather than a full face mask.

  • Their size makes some people feel more claustrophobic compared to other types of CPAP masks.
  • They are more likely to have air leaks due to covering a larger portion of the face.
  • They tend to be less comfortable than both nasal pillows or nasal masks.
  • They are oftentimes too bulky to use while side sleeping.
  • They may limit movement during sleep.
  • They can cause skin irritation on the face.
  • They may block your field of vision, making reading or watching TV difficult.
  • If the seal is lost, a full face mask may leak above the nose, causing dry eyes.
  • They oftentimes have trouble sealing against thick facial hair.
  • There is evidence to suggest that these masks may require higher air pressures to be effective.

Related Articles: Best Full Face CPAP Masks

Factors to Consider When Choosing Between CPAP Nasal Pillows vs Nasal Mask vs Full Face Mask

When it comes to choosing the CPAP mask that is right for you, there are hundreds of options! So if you find yourself struggling to continue treating your sleep apnea through CPAP therapy, it may be time to try out a new mask that is better suited to your needs. Here are some things to consider!

Facial Hair

Having a beard and/or mustache can make it more difficult for you to get a good seal with your sleep apnea mask. This tends to be a bigger problem with full face masks. However, facial hair can also lead to air leaks with a traditional nasal mask, particularly on someone who has a thick mustache. For this reason, nasal pillows are often suggested to people who prefer not to go clean shaved.

Sleep Positions

It’s no secret that sleep apnea treatment can mean bulky equipment, including headgear. Plus, with all those added tubes and hoses, it can sometimes be difficult to get comfortable if you don’t have the right mask. While full face masks are fine for people who sleep on their backs, more compact options, such as nasal pillows, provide more flexibility for side sleepers, stomach sleepers, or those who toss and turn at night.

Related Article: Find the Best CPAP mask For Your Sleeping Position

Comfort Level

People who are new to CPAP therapy often complain that their new gear makes them feel claustrophobic and can make it harder to fall asleep. Unfortunately, this can lead some to discontinue treatment early. If you are someone who struggles with feeling restrained or having a mask on your face, it may be better to go with a smaller option, such as the nasal mask or nasal pillows. That said, if you have a sensitive nose, having direct airflow straight into your nostrils may not be ideal.

Security

Traditional nasal masks and full face masks oftentimes have similar head straps that hold the mask in place over the bridge of the nose and along the mouth. Nasal pillow masks are often quite secure, thanks to the nasal pillow design. However, they also tend to have fewer and smaller head straps. So, if you feel that you cannot keep your nasal pillow mask secured to your head, you may want to try out a traditional nasal mask.

Seal

As a general rule, the larger the mask, the harder it is to maintain an airtight seal. For this reason, full face masks have a higher risk of air leakage compared to nasal masks. And thanks to their pillow design that inserts directly into the nostrils, nasal pillows tend to provide the most reliable seal.

Nasal Anatomy

As their name suggests, nasal CPAP masks require you to breathe primarily through your nose. This can be an issue for those who have chronic sinus congestion or abnormal nasal anatomy, such as a deviated septum. Additionally, some people may find these types of masks to be difficult to sleep with while sick or during an allergy spell. However, there has been research to suggest that the flow of warm, humidified air may actually improve minor congestion in those situations.

Alternative Options

CPAP masks have come a long way with new features and styles. So, if you are looking for something that better fits your needs beyond what we’ve discussed here, there are several other options to choose from.

Alternatives include:

  • Nasal Prong
  • Nasal Cradles
  • Hybrid
  • Oral
  • Total Face Masks

Final Thoughts

Choosing your CPAP mask can sometimes feel like a bit of a chore, so it’s important to know your options.

Nasal pillows are often a favorite among sleep apnea specialists, due to their compact size and increased comfort. However, the majority of people prefer the middle-ground option of a nasal mask, because of they are a bit more gentle and are far less bulky compared to a full face mask. Meanwhile, full face masks are still a good choice for mouthbreathers who prefer to sleep on their backs or need high flow pressure settings.

And if none of these sound right for you, remember that there are tons of other designs and styles out there! So, if you’re struggling with finding the right fit, give it some trial and error. The right mask is out there!

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