CPAP Mask Leaks

Key Takeaways

• CPAP mask leaks are often caused by poor mask fit, worn cushions, incorrect mask type, or sleeping position, and may worsen over time as equipment ages.
• Common signs of mask leaks include dry mouth, noisy airflow, eye irritation, and persistent sleep apnea symptoms, even while using CPAP.
• Most mask leaks can be fixed with simple adjustments, such as refitting the mask, replacing cushions, adjusting straps, or switching to a different mask style.

Causes of CPAP Mask Leaks

CPAP mask leaks are associated with a number of factors, including the type and condition of your mask. Personal characteristics (like your preferred sleeping position) can also make you more likely to have a mask leak. 

• Poor mask fit: A proper mask fit is important to avoid side effects like CPAP leaks. That includes a good seal around face parts. A mask may fit too tightly, making the cushion around the mask frame not function correctly.
• Wrong mask type: Certain mask styles may not work well for mouth breathers, side sleepers, or people with facial hair.
• Old or damaged mask: Cushions, seals, or headgear can degrade over time and lose their ability to maintain a proper seal.
• High air pressure: High amounts of air pressure correlate with an increased risk of unintentional leak.
• Movement during sleep: Changing positions or tossing and turning can shift the mask and break the seal.
• Facial hair or skin oils: Beards, mustaches, or excess skin oils can interfere with how well the mask seals against the face.

Other characteristics can put people more at risk for mask leaks. These include higher body mass index (BMI), male sex, older age, nasal congestion, smoking, and health conditions like chronic obstructive pulmonary disease (COPD).

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Signs Your CPAP Mask Is Leaking

Manufacturers of CPAP machines have different thresholds for what constitutes an unacceptable level of mask leak. Most CPAP machines can assess and adjust for these to some extent. However, there's no consensus about what constitutes an acceptable amount of leak versus a problematic one. 

Talk to your doctor if your machine gives any indications you may be experiencing a leak. These include:

• Air blowing into your eyes or face
• Dry mouth, nose, or eyes
• Nasal congestion
• Whistling, hissing, or rushing air sounds
• Sleep fragmentation or multiple awakenings
• Red marks, soreness, or pressure points
• Higher leak rates or elevated AHI readings
• Complaints from a bed partner about mask noise

How to Stop CPAP Mask Leaks

A personalized solution is best for addressing mask leaks. You have a number of options, and which action to take depends on your specific needs and preferences as well as your doctor’s recommendations.

Make Sure Your Mask Is Clean

A dirty mask is more likely to leak because oils from your skin can prevent the cushion from sealing properly. Clean your mask daily with warm water and mild soap to remove buildup that can cause slipping or gaps. Let all parts air-dry completely before use, as moisture can also interfere with a proper seal.

Adjust the Fit of Your Mask

A mask that’s too loose or too tight can both lead to leaks. Start by loosening the straps and refitting the mask while lying down in your usual sleep position, then tighten gradually until the seal feels secure but comfortable. Over-tightening can distort the cushion and actually increase leaks, so aim for a snug—not tight—fit.

Put on Your Mask Correctly

How you put on your mask matters. Always position the cushion evenly against your face before securing the straps, and turn the CPAP machine on while adjusting to help identify leaks. Many people find it helpful to fit the mask while lying down, since facial muscles relax and change shape compared to sitting or standing.

Replace Your Mask or Cushion

Mask cushions wear out over time and may lose their shape or elasticity, making leaks more likely. Check your mask seal periodically or if you notice signs of wear. If your mask no longer seals well despite proper cleaning and adjustment, it may be time for a replacement. 

Most cushions need to be replaced every few months, and masks themselves may need replacing every 6 to 12 months, depending on wear and insurance coverage.

Switch to a Different Type of Mask

Changing to another type of CPAP mask is possible, but it's important to work with your doctor to find the source of the leak before switching. For example, oronasal masks are most appropriate for people who breathe through their mouth while sleeping. Sometimes choosing another brand may also help.

Add a Chin Strap

Adding a chin strap has been shown in a few studies to limit leaking by reducing mouth opening. This approach appears to be more successful with people who have a lower level of mouth leak. The medical community isn't in agreement about the long-term success of a chinstrap. If you use one, it's best practice to pull the top part of the straps forward on your head to avoid pulling the jaw backward. 

Use a Humidifier

Use of a CPAP humidifier is recommended to improve a person’s comfort and regular use of CPAP therapy. Most CPAP machines come with humidification and a recommendation to use this feature. One study indicates that use of a CPAP humidifier may help people with nasal congestion and reduce mouth leak.

Try Mask Liners

Mask liners can help reduce leaks by creating a soft barrier between your mask and your skin. They absorb moisture, reduce skin oils, and help fill small gaps that can cause air to escape. Many people also find that mask liners improve comfort and reduce skin irritation, which can make it easier to maintain a proper seal throughout the night. Liners are available in disposable and reusable options and can be used with most mask types.

Double Check Your Pressure Settings

If your CPAP pressure is higher than necessary, the extra airflow can force air out around the edges of your mask, even if it fits correctly. If you continue to experience leaks despite proper fit and mask care, it may be a sign that your pressure settings need to be reviewed.

Talk to your sleep specialist about ongoing leaks so they can evaluate your therapy data and determine whether a pressure adjustment or different device settings may help. You should never change your pressure settings on your own without medical guidance.