CPAP is a very successful treatment for sleep apnea–in people that use it. Compliance is a big problem among CPAP users. Even setting a fairly low standard (at least four hours a night on 70% of nights), many studies show compliance rates are just 50% or below.
Now researchers are proposing that a new approach to making CPAP masks may be able to improve the CPAP experience and therefore compliance. Although it’s likely that the new masks could help, the mask is only one of the problems that keep people from using CPAP.
Customized Masks Can Improve Fit
Although the CPAP mask should be a custom piece of equipment, it’s usually just taken off the rack. The mask is designed to try to use flexible fittings to try to get around the poor fit. Although this can work to some extent, it creates its own problems. Pulling the mask on tightly enough to create a seal against the skin means the straps are on tighter than is comfortable. And the pressure pushing the mask against the face can also be too much. This can lead to skin irritation and acne. To try to reduce irritation, many people make their own mask liners.
And even with the tight straps, the mask can often develop air leaks around it, reducing the effectiveness of the treatment.
But with a customized mask, the hope is that the mask will be capable of creating a tight seal without too much pressure. That can reduce skin irritation and improve effectiveness. Ideally, this will lead to better compliance and better results.
CPAP Just Isn’t for Everyone
But even with improved fit for the mask, there are still many problems people experience with CPAP.
One of the problems is the mask itself. Even if it fits perfectly, many people will likely feel that the mask is too smothering. CPAP masks can cause feelings of claustrophobia and may induce nightmares, especially in people with PTSD.
And then there’s the limitation and nuisance of the tube connecting the mask to the pump. The tube itself can restrict movement at night, and can lead to irritation.
Many people also dislike the sensation of having air pumped into them. Dry mouth and other irritations can occur, as the air is forced into the airway. People can swallow air and experience discomfort.
Add together all these factors, and there are many people who will just not be able to adapt to CPAP, no matter how comfortable the mask is.
Oral Appliances Are Already Customized
This is yet another way that oral appliances offer a better experience than CPAP. Unlike picking a mask off the rack, your oral appliance will be custom crafted for you. The appliance is precisely fitted to your teeth and jaw position so that it is very comfortable and easy to wear. That’s why so many more people are able to wear oral appliances all night every night, rather than just meet the low standard for compliance with CPAP.