CPAP therapy can have immediate positive effects on your sleep. Though there’s a period of adjustment while you get used to the feel of the pressurized air and mask, many people notice right away that there’s a difference in their energy level after a night or two of CPAP therapy.
They may wake up without the sore throats and headaches associated with apnea, and their daytime sleepiness improves a little more each day they continue therapy. In fact, one study suggests that the longer you use your CPAP, the more you’ll see your apnea symptoms improve.
If, however, you notice any of these common side effects or a backslide into your old symptoms after a while — if you’re waking up tired, if your head hurts, if your throat is raw, if you feel exhausted, or if your partner reports that you’re snoring again—don’t give up on your treatment. You haven’t built up a resistance to CPAP therapy. Your apnea may not be getting worse. The issue could be far simpler: your CPAP mask may have a leak.
Why Does a Mask Leak Matter?
The effectiveness of your CPAP therapy depends on your getting the right level of air pressure delivered to your airway via the CPAP machine, tubing, and mask. This air pressure has been determined during your titration study and prescribed by your sleep medicine physician. It’s precisely what you need to keep your airway from collapsing.
While all CPAP machines and masks are designed to have a certain acceptable level of intentional leak (so that you can exhale CO2), an unintentional leak from a hole or a weak seal around your nose or mouth can bring the air pressure too low, outside the acceptable range.
If this happens, you may not be getting sufficient pressure. This means you could wear your mask all night but still experience a partial or full airway collapse. Your therapy is compromised.
A mask leak can be bothersome in other ways, too. Leaking air can reach your eyes and dry them out, causing irritation. A mask leak may also make a whistling or hissing noise that wakes you or your bed partner, contributing to fragmented sleep or insomnia.
To make sure your therapy is effective, a CPAP mask leak needs to be found and addressed promptly.
What Causes CPAP Mask Leaks?
A number of different factors may cause your apnea mask to leak. These include:
Poor fit – If your mask is not fitting you properly—for example, if there’s gapping around your cheeks or mouth—the seal may not be tight enough, and air may escape through this broken seal. Adjusting your headgear poorly can have the same effect; if the elastic straps are too loose or too tight, your mask won’t function properly.
CPAP mask cushions normally contain two layers; if the fit to your face is too tight, the outer layer can’t inflate to create a firm seal. If you’re not sure how to fit your mask to your face, ask your sleep technicians or supplier for guidelines.
Also, look to get a new mask or a new fitting after gaining or losing a substantial amount of weight, like weight gain and loss can affect the shape of your face and how well your mask creates a seal.
An old mask – If you’ve been using the same CPAP mask for longer than is recommended, it may begin to show signs of wear and tear. The silicone may soften and become thin, which can lead to cracks, tears, or holes. Or the cushioning around the mask may degrade, affecting the quality of the seal.
The straps that hold the mask to your head may also stretch out and become too loose, causing the mask position to slip. Remember, the guidelines are to change your mask cushions every 1-3 months and your mask every 6-12 months.
Dirt and oils degrading the mask – It’s important to keep your apnea mask clean; if you fail to clean it weekly (and to clean your face nightly before going to sleep), the dirt and oils from your skin can stick to the cushioning and break the seal, particularly as air pressure from the CPAP machine increases during the night.
Sleep position – If you are a restless or very mobile sleeper who tosses and turns a lot during the night, these changes in sleep position may disrupt the placement of the mask on your face. Some people even tear their masks off in their sleep.
High air pressure – Research indicates that high CPAP pressure can increase the likelihood of experiencing unintentional leakage. If you require high pressure for your therapy, keep a close eye on your symptoms and your machine readings. If your leakage is going outside the acceptable range, talk to your sleep physician about ways to compensate for this possible pressure loss.
Mouth breathing – Studies show that mouth breathing when wearing a nasal mask can also contribute to leakage. An oronasal mask (one that covers the nose and mouth) can help to compensate.
Deviations from the expected routine – The American Thoracic Society website shared two interesting case studies about why patients who stick to their therapy experienced unintentional mask leaks. It turned one patient had leaks because she decided to wear her mask over hair curlers.
Another patient realized her cats had been chewing on her mask and tubing. When finding the cause of your apnea mask leaks, sometimes you may need to put on your detective cap and do some sleuthing to eliminate variables. The more information you can gather about your equipment, your habits, and your sleep hygiene, the more likely you are to solve the mystery of why your mask is leaking.
What to Do if Your Sleep Apnea Mask (CPAP Mask) Has a Leak
Check your fit and seal – Sometimes a poor seal occurs because people put their apnea masks on incorrectly. The proper way to put on a CPAP mask, according to the American Sleep Apnea Association, is to secure it loosely to your face while you’re sitting in bed. Next, turn your CPAP machine on.
After lying down in your typical sleep position (back, side, or stomach), tighten your straps until you get a good seal, but don’t overtighten. Lastly, seat your mask by pulling it an inch or two off your face until the outer layer inflates. Then lower it. The dual layers of cushioning ensure a more secure seal.(4)
Try a new style of mask (or a new CPAP machine) – A full face mask that goes over the nose or mouth may be more effective if you breathe through your mouth. If you already use a full face mask and still have leaks, a nasal-only mask with a chin strap may be helpful. A different style of machine may also help—for example, a BiPAP or APAP.
Replace your worn mask – An old mask (older than six months to a year) will need to be replaced as the silicon and cushioning wear out. Call or visit your supplier to discuss options.
Ramp up your pressure – Using the ramp function on your CPAP will gradually raise your pressure, minimizing the likelihood of breaking your seal or causing discomfort that makes you remove your mask.
Get mask accessories to help – Talk to your CPAP supplier if you have problems with leaks. CPAP mask accessories like a mask sealer, full face liners, nasal mask or nasal pillow liners, nasal gel pads, CPAP cushions, and eye shields can help to stop or minimize leaks and the annoyances associated with them.
A leaking CPAP mask is not a disaster—it’s usually a sign of either an improper fit or a need for replacement parts or accessories. Keep trying until you find the problem, and stay in touch with your physician and your supplier. They want to help you get the best possible experience with your therapy.
David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.
29 thoughts on “CPAP Mask Leaks: Causes and Solutions”
The article states, “Remember, the guidelines are to change your mask cushions every 1-3 months and your mask every 6-12 months.” Keep in mind that these “guidelines” are from the manufacturers and from the sellers, who have a vested financial interest in our purchasing new product frequently. There is little objective science behind these “guidelines.” The user should inspect equipment carefully as part of the daily cleaning process, to determine the need for replacement.
Hi Velbor, here at CPAP.com we never pressure any customer to change their products. The recommended change schedule is put in place because the supplies are not made to last forever. We certainly encourage all of our customers to seek knowledge as of the importance in keeping all CPAP supplies cleaned and replaced.
I have added a link of our recommended replacement schedule which also list a reason for the recommendation of each item.
Enjoy your day!
What is a mask sealer?
Hi Lyn, Mask Sealer is cream, or gel used to help stop your mask from leaking air. We do not cell any mask sealer at CPAP.com, but I have listed a link below of an option for you with a different company.
Please let us know if you have any further questions, or concerns. We can be reached at 1-800-356-5221.
Have a great day!
I have had this problem for some time and my doctor is not addressing it properly.
He wants to put me on a narcotic drug to keep me alert during the day. I have to sign a form
and return every three months (and labs) to monitor me. I said No thankyou. This is my “Standard”
answer. Any suggestions would be appreciated.
Hey May, I am sorry that you are having problem with mask leaks. For starters, you must make sure that you are using the correct size cushion, secondly, you want to make sure you are keeping your cushions changed out every 3 months and change your entire mask ever 6 months to help reduce your leak rate. If you continue to have leaks, maybe the mask that you are currently using is not a good fit for you.
Mask leaks are very common with CPAP users, and a lot of times those leaks are only conquered by trial and error. This means you have to just continue trying different masks, or making adjustments to your current mask until you get a good fit. If you have a local CPAP Supply Provider in your area, you may be able to get assistance there for sizing suggestions and by trying on different masks.
I hope this information helps some. We wish you the best!
The bridge of my nose is unusually high and face frame is petite. I need a mask to be able to cover all these issues and stay sealed.
Hi Mary, I’d be happy to recommend a mask that may work for you. What type of mask do you prefer (full face-covers nose and mouth, nasal-covers nose only, or nasal pillow-cushions inserted into your nostrils)?
You may either reply to this thread, contact us at: 1-800-356-5221 ask for Carol, or you may e-mail us at: email@example.com Attn: Carol.
I hope to hear from you soon!
Can you or someone please please help me I ordered my third one now the pillows in a small instead of a extra small and tried nasal one in medium which was worse but I feel like it’s collapsing in my nose. It’s quiet and idk if that means it’s collapsing or it’s suppose to be like that. Or if I should pull it out and have it lay on top of mouth so I can at least feel and know I’m getting the oxygen. I’m in my twenties and this is very frustrating especially knowing I’ll have it forever and had it for years! Thank you
Hi Nicole, I would be frustrated too if, my pillows were collapsing. Have you changed your nasal pillows recently? Most nasal pillows should be changed every 30 days. Also, if you are using the wrong size, the pillows this may cause the pillows to collaspe.
Please see the link below to read what other CPAP users are saying about their pillows collasping.
If switching to a different size does not keep the pillows from collapsing, you may want to try a different mask altogether. CPAP.com offers free 30 day returns on all complete masks purchased from us. This way you can try the mask and if you don’t like it for any reason, you may return the mask for your money back, or a different mask.
For further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may e-mail us at: firstname.lastname@example.org.
Have a great day!
I have a scar just below the bridge of my nose that is slowly getting redder and sorer and is slightly swelling due to my mask. Is there any cream, etc i could apply to this and still keep my ‘air leaks’ from occurring? This email address allows you to respond but i am unable to answer.
Hey Janet, i’m sorry to hear about the skin problem you’re experiencing due to your mask. To help with skin irritations, you may want to use a mask liner, such as Remzzz’s, or Silent Night. Also, please see the links below for other possible options to help reduce the irritation from your mask.
For further questions, or concerns, please reach us at: 1-800-356-5221.
We wish you the best!
I pyrchased a max liner and now my machine indicates that the seal is poor. This didn’t happen before. What would cause this? I have tried to enlarge the hole in the liner.
Hey Kathy, my first thought would be you’re possibly using the wrong size mask liner. If you would like assistance in confirming if you are using the correct liner for your mask, please feel free to contact us at: 1-800-356-5221 with your mask and liners near you.
We wish you the best!
I have been a CPAP user for several years and have always had issues with “leakage”. We’re not quite sure where it comes from, but it wakes my wife up almost every night. I have a full beard and mustache. I am also a side sleeper. I started out with nasal pillows with my machine and they would never stay in place. My pillow would push them off. I also used a chin strap in an effort to keep my mouth closed during sleep. That slipped off as well. I then switched to a triangular shaped nasal mask. It works a bit better, but I am still encountering leakage to the point that I move to the guest room so my wife can get a good night’s rest.
Any thoughts out there?
Hi Fred, i’m sorry to hear about the leak that you are dealing with, sounds like its causing disruptions in your life. Sometimes, in order for you to find a mask that works well, with no leaks its simply trial and error.
I understand that you started out with a Nasal Pillow mask, but had trouble with it not staying in place. There is a mask that was released in the early part of this year called Bleep DreamPort. Please see the link below for more information. This mask may work well for you in conjunction with a chinstrap. The Bleep, will stay firmly in place during the night, and it would be a great alternative to a full face mask since you have facial hair and mask leaks are pretty much non-existent.
You mentioned that your chinstrap slipped off once before, you may try a different chinstrap to see if it works better, or another mask suggestion would be the Tap Pap Nasal Pillow. This mask would remove the need of you needing a chinstrap because you could bite down on the guard and this may help keep your mouth from falling open during the night. You can read more details about this mask by clicking the link below.
One other option, that may work well for you is a full face mask called the AirTouch F20. This mask has a memory foam cushion that folks are usually able to keep a good seal, even with facial hair. The downfall to this mask is that the memory foam cushion must be changed every 30 days and that can get pretty costly. To view more information, please see the link below.
I hope this information helps! For further questions, or concerns, please feel free to reach us at: 800-356-5221, or you may e-mail us at: email@example.com.
Have a wonderful weekend!
I am a new cpap user and using a nasal mask. I’m also using a new device that works like as if you were putting a bandaid over your mouth. The problem when it ramps is the air not only ramps up my nose but completely fills my mouth! It wakes me every time. Any advice would be appreciated. Thank you
Hi Linda, my apologies for the delayed response. It sounds like you could be experiencing Aerophagia. This means swallowing too much air.
Also, since you have a band-aid type device over your mouth, there may not be any room for the air to escape, so that could be the issue.
I would recommend you speaking with your doctor to see if a pressure reduction would be beneficial to you.
For further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may e-mail us at: firstname.lastname@example.org.
Have a great day!
why would my machine start to leak air and make a sputtering sound?
Hi Terry, it sounds like you may have a mask leak. Have you changed your mask cushion within the last 3 months? In addition to changing your cushion, you should change your entire mask every 6 months.
Also, you should be sure that your hose isn’t leaking air. You can perform a simple test by removing your mask from the hose, turn your machine on and cover the end of the hose that you removed your mask from tightly with your hand. Confirm if you can still hear the noise, if not you should change your mask. If so, you should change your hose.
If changing your mask and/or hose does not stop the leaking air, or the sound, please feel free to reach us at: 1-800-356-5221 and we will be happy to assist you further via phone.
We wish you the best!
Certain models of ResMed machines with water reservoir will make that sound when the water reservoir is not installed correctly. The pipe from the reservoir misaligned during insertion after refilling and it leaks. Just pull the tank out and re-insert it to fix the problem. I have had that problem where the machine ran all night and reported air loss, but I could find none. The misalignment occurs maybe once in a hundred insertions and feels like the tank is correctly replaced, but the sound of the machine is subtly wrong.
Another possibility is water in the air line. Condensation builds up and runs down to form a puddle which gurgles when the air moves by it. Overfilling the water tank can also cause water in the lines. Just clean the water out of the hose by holding it vertical and/or running dried air through it as from a hair drier. It doesn’t take much once the water is dumped out of the hose.
I have a full face mask I think; it does not cover my nose but does cover my mouth. I go 3-5 days with the maskat 85-95% then 4 or 5 days with 50 or 40 or even 20% meaning a lot of leakage. However the readings of my AHI and Periodic Breathing remain fairly constant with the former averaging 2.7 and the latter 1. While the Mask Fit figures indicating leakage is a concern of course, the figures for which the machine is used seem to be very good. Not sure what to do although I know my Primary Care doctor will suggest all kinds of remedy’s for the mask fit. Would sure like an opinion on my situation.
Hi Donald, I apologize for the delayed response. What is the name of your mask? Have you confirmed that you are using the correct size cushion? Also, have you changed your mask cushion within the last 3 months and changed the entire mask within the last 6 months? If not, please do so.
If you have recently changed your mask, please feel free to reach us at: 1-800-356-5221, so that we may further assist you.
We wish you the best!
Hello I’m wondering why after wearing the CPAP machine I begin to have some nasal or airway congestion throughout the day as if I can’t breathe but I know I can it’s an uncomfortable stuffy feeling when I’m done using the machine
I’m sorry to hear about the bothersome congestion you’re experiencing. CPAP air is an irritant – to one degree or another – to everyone. The irritation may cause the nasal passages to dry out and bleed, or the mucous membranes may try to protect the nasal passages by producing excess mucus, resulting in congestion.
Are you currently using a humidifier? If not, if your machine has the option, you may benefit by adding one.
You may try using a Sinus Rinse before going to bed and after you awake. Please see the links below for a couple of rinse options we currently stock.
Some CPAP users have reported a decrease in congestion, by adding a bacteria filter with their therapy. Please see the link below for more information.
I hope this helps, for further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may email us at: email@example.com.
We wish you the best!
Wow! I was having leakage issues too but trading these comments was extremely helpful!!! Thanks!
I am over 75 years old and have been using a CPAP for several years (at first diagnosed with sleep apnea, then not, then diagnosed with sleep apnea again a couple of years later.Now for the last 3 years, I have used several different machines – currently a BIPAP version of the ResMed AirCurve 10 VAUTO. This machine seems to work the best and at least reports the UA events as OA events.
I am experiencing so much discomfort from the full face mask that I use because the mask must be pulled so tight to prevent air leakage and even then if I move my head to a different position, the mask will leak. Sometimes it will continue to leak until I open my mouth.
I started with the half mask which did not last long so I requested a full face. During fitting, I was having problems with the higher pressures on my face and finally achieved some modicum of acceptability from a ‘large’ full face mask. It works well and is comfortable much of the time, but when the pressures reach above 14 – 15 psi, it begins to cause trouble as well. The graphs from the data show that the pressures are maintained at as much as 20 psi with the normal amount being 17 psi consistently all night long. At 17 psi, there is so much pressure on my face and to withstand that much all night? My face becomes sore on the nose bridge and over the face – welt-like places appear which quickly dissipate, but I feel them all day. Sometimes it becomes so unbearable that I remove the mask and sleep without it. I am running an AHI of 25 – 45 only occasionally is it less, but when it is less it gets as low as 2 all night.
I am getting real tired of this! It seems like the CPAP machine wakes me up more than the apneas do. My real sleep is almost nonexistent and I end up so tired that I fall asleep finally wherever I am – for just a short nap – then I can go again for awhile, but it happens as many as 5 times a day and then I dread the night because I have to deal with the CPAP again. OK I do get some all-nighters where it cannot wake me up, and they have been more prevalent as my usage has increased, but they appear to be extreme exhaustion.Then inexplicably there will be a short period of low AHI and almost no events for a few nights followed by a return to the same old stuff night after night.
I’m so sorry about the challenges you’re having with your BiPAP therapy. It sounds like your troubles are all stemming from your ill fitting mask.
To begin, with you having to pull your headgear so tight that you’re experiencing discomfort, signals you have a poor mask fit. Have you measured yourself to make sure you have the correct size mask? If not please do so.
Your machine has an option for you to run mask fit. Please do so, if you receive a happy face, mask fit is good, if a sad face appears, this indicates you need to adjust your mask. If you need assistance with completing the mask fit check, please call the number listed below and we’re happy to help you.
Also, please keep in mind that not every mask will work for every person and you may benefit from trying a different mask.
I’m not certain of the cause for the high pressure you’re experiencing, but it could be that the machine senses you need a higher pressure due to apneas, but mask leaks could be contributing to you leveling out at such high pressures. If your machine senses a mask leak, it tends to push more air to compensate for the leak.
Please check your therapy data to confirm your leak rate. If it’s over 24L/m, this could be an indication that again, your mask should be changed, or fitted to a better size for you.
We sell mask liners that you may consider, which will help decrease mask leaks, and lessen the skin irritation you’re experiencing. Please see the links below for a couple of our stocked items.
Please see the link below for a product that may help relieve the pain on the bridge of your nose.
I would encourage you to speak with your doctor regarding the difficulties you’re having with your therapy as your doctor, should be able to review your therapy data in depth, to determine if any setting adjustments are warranted.
I hope you soon receive improved therapy and if you’d like to speak with us further, please feel free to reach us at: 1-800-356-5221.
I had trouble with leakage until discovered how to fit the mask.
What I do is make sure the holes in the mask line up with my nostrils
Then i make sure the bottom of the maskis tucked under and no leakage
The mask I am using is ts the one that fits under the nose and over my mouth
It took a lot of frustration before I was able to remedy the problem.
Do hope this may help other people with their frustration