DECEMBER POLL RESULTS

January 9, 2008

Our October and November Polls asked men and women CPAP users to comment on mask choices and whether or not the different sexes had unique priorities or considerations for mask choice. You responded with an overwhelming YES. Therefore, we decided to go one step further and survey you again in December, giving you the opportunity to speak directly to the CPAP mask developers. You were encouraged to speak to the good, bad and ugly features of masks you have tried. You were also asked to provide your ideas and suggestions for future interface products. We received a plethora of responses and we thank you very much! We have summarized your responses below. Many of the responses were similar yet we wanted to give the manufacturers the entire commentary thus alerting them to the issues that seemed important to so many of you.

We offered all poll takers the opportunity to participate in an opt in drawing.
Congratulations to our 2 winners:
Joyce K. from Minneapolis, MN who won a Double Edge PAPillow
Michael F. from Anchorage, Alaska who won a PAPillow™ brand zippered insulated tubing cover.

Women CPAP User Responses

Men CPAP User Responses

Women CPAP User Responses

What are your challenges with and suggestions for improvements with headgear?

Make a soft hat like headgear; would be more hair friendly
I don't want it to mess with my hair or give me zits & wrinkles. I would like to be able to wear night creams!
Use a softer material so doesn't leave strap marks on the side of your face.
I would like to see smaller headgear
Make headgear that is sized smaller and is more adjustable.
Our heads are not shaped like bowling balls! Stop making masks and headgear as if they were!
Make headgear that will stay in place on slippery hair.
Make a mask that does not require headgear
The standard head gear is too large. Where the sides are adjustable the length is not and that is where I have my problems
The marks on my face from the headgear take a long time to go away. If I have to go out right away in the morning I look like I have a serious scar.
Headgear caused facial wrinkles and "mask hair" in the morning are annoying.
Avoid suffocating and irritating straps on face and on lower back of head.
I hate the way it creases my hair so I have to wash hair every morning before going to work instead of the every other day I was accustomed to and which is better for the hair.
Women over 50 and certainly over 60 have thinning hair -- it's important to have adjustment tools that won't pull on the hair and won't slip.
Headgear leaves strap marks on my face and messes up my hair.
Socially embarrassing to sleep with a strappy mask
The headgear is too long. I take a tuck on each of the back straps with safety pins in order to keep it from slipping off the top of my head and make sure it holds the top of the mask in place.
The Headrest's rubber headgear is horrible because it pulls hair. It is also too large, I have it on the smallest setting and it is still too large.
Velcro is great to use and the straps should be easily adjusted. Many suggest removing the headgear from the headrest and tying it on with women's tights. I am probably going to try this.
My challenge is having only one hand and the only mask I have found that can be taken off like a baseball hat is the ResMed Swift 2
I would like to see headgear made smaller from the start, not just with adjustable straps. By the time I cinch some down, I have straps over my eyes or buckles on the back of my neck.
Soft colors in headgear would be a nice touch.
Would be wonderful if headgear material is made from more tender material. The Velcro is handy, but it is irritating when it rubs against my cheeks.
I want side sleeping without leaks, headgear that stays in place, I don't want to look like a major bedhead in the morning. Don't want marks on my face from the straps
I have arthritis and my manual dexterity is not good. It would be nice to have masks that do not require such intensive adjustments for those of us with little strength and control over our fingers!
Fewer and smaller straps crossing our heads, the less our hair will tangle and cause the headgear to slip.
Something that doesn't totally mess up my hair.
Sliding up the back of my head. Makes a linear mark in my hair.
Better gripping for straight smooth hair.
We have a small nose compared to men and the head gear needs to be smaller. Mine is constantly coming over the top of my head.
Headgear is too hard on hairstyles! Can you not come up with a design that does not smoosh up your hair so bad?
My very thick hair is longer and gets stuck in the headgear.
The head gear is too big. ALL straps should be adjustable. Also all straps should pivot, so that they would adjust to each individual head.
Minimum skin contact to eliminate skin blemishes.
Challenges: Sizing and adjustment. Dealing with longer hair getting caught in Velcro; skin reactions to parts of headgear that make contact with the face especially when needing to use evening moisturizers.
Somehow make it more comfortable to be able to lie on my side while wearing the mask.
Some headgear seems to stretch out too quickly and no longer will stay on the head. And then there isn't enough Velcro to hold it in the size you first set it...
Head gear is too long. The length from the top of the head to the neck needs to be shorter for me. There is no way to adjust that.
Most headgears are much too large for me. I have to cut them apart and sew them together so they're small enough to fit my head.
I have very slippery hair. Most headgears do not remain stable on my head during the night; they slip and slide out of position.
I wish headgear came in beige or white.
I wish more masks offered a petite size. I wish headgear was not made for just longer heads than mine! I have recently made my own headgear for the petite comfort gel mask. simple 3/4 inch white waistband type elastic held together with safety pine. It doesn't mess up my hair all night.
I want a mask with NO headgear. I hate having to wash and blow dry my hair every morning to get rid of "headgear hair".
Figure out how to get rid of straps at the base of the neck and the head-tightness causes headaches, tightness also causes pressure on the face such as nose and upper jaw. A one strap headgear might be nice.
The top part of the head gear that supports the mask on my forehead is awkward. If I tighten the straps the bottom of the mask will pull outward and leak air. However, if I don't tighten the strap, the top will pull out from my forehead and leak air there as well. I can't win.
I want a mask that will allow me wear my glasses to either read or watch TV before falling asleep.
There have been only 2-3 masks out of 20 or more I have tried which actually maintain a seal all night when my face makes contact with my pillow or my arm.
Hard to get a firm placement fit to keep air in and if we do we have red pressure points in the morning.
Avoid using Velcro headgear around the face area, especially around the eye area. Better still, avoid using Velcro! Headgear should be adjustable in such a way, so that on a wide face/head, the sides of the headgear do not close in towards the face.
I often wake up and have to move the headgear up from the top of my ears, because it hurts and is putting too much pressure on my ears. Please use something softer where the headgear touches the top of the ear.
I'm a restless sleeper so I don't want the headgear to move around so much. Perhaps, a netting cap that would hold the straps more stationary. I also don't like any drafts blowing in my eyes so I would like this problem to be solved.
I want my mask to be small, soft and flexible
The plastic buckle on the back of my mask makes me wake up with a headache most of the time. I was frustrated with the straps leaving creases on my cheeks, so I wrapped cloth strips around the straps so the edges of the foam don't cut into my cheeks so much. I also did this on my separate chin strap and it helps cushion the part where the chin rest is sewn to the strap - makes it a little more comfortable.
Most headgear is too large.
Make them smaller to fit WOMEN
I've found just using the Velcro on the straps to be more convenient than the various snaps, etc. used for adjusting, donning and removing the headgear and mask. I've finally found the Respironics Simplicity nasal cushion works best for me. My complaint with is that I have to cut almost or about 2 inches out of the middle of the center head strap and I have to use scissors to taper the Velcro ends to the bottom straps because they are the same width as straps themselves, meaning if one isn't extremely careful in placing the Velcro straps they dig your neck raw unless you taper them. I doubt Respironics will respond to this because the Simplicity is one of their oldest masks.
I have the Mirage liberty. The plastic pieces cause acne. Is there a way of making them a mesh? I don't see why they have to be solid.
CPAP masks straps = BAD HAIR DAYS
They seem to be too large for my small head. Most headgear I have used have WAY too many adjustments to be made. It would be nice for there to be just one strap going around the head where you adjust each side one time and be done with it.
I don't like a head gear that you have to slip over your head. I like the new ResMed Mirage 2 but wish I had the head gear from the old Mirage full face mask. Just wrap it around and hook it. Sometimes during the night my nose will itch, easy access by just unclipping, scratch, clip back in place. You can't do this with new Mirage 2 headgear
Would like a mask that doesn't leave marks on my face in the morning. My hair also breaks off at the level where the strap goes across the back of my head.
I like minimum straps on my face. I prefer something like a cap for my head only. I really don't even like straps on the back of my head, they get irritating and I end up pulling the whole thing off. I am also concerned about hair loss from the headgear. Could you make headgear that attaches to your chin instead of your head?
My hardest part of using a mask is that I have lots of sinus issues. I'll often wake up with face pain (pressure) and can not sleep on my back as my drainage heads to the back of my head and gives me a headache. The longest I have been able to tolerate my mask is 4 hours at a time.

What are your challenges with and suggestions for improvements with nasal mask frames?

I have a smaller head and although I use the petite comfort gel mask it is still too wide for my face. It hits on my cheeks and if I move them during my sleep then the seal breaks and I have leaks that wake me up. I really would like to have a mask that was unobtrusive and uses less straps.
My nose is smaller and the small mask is still too large.
My skin reacts badly to the plastic after a few days.
Too hard....I sleep on my side and waken often to find the hard part of the mask digging into my cheek and hurting.
Women's faces and nose bridge are usually smaller and narrower then men. Also, in my case the mask goes from the lip to about 1/2 inch below the bridge. When they make masks they make them narrow or wide but not long or short
I think the frames are too large for the space between my nostril and lips. I have used the ResMed Swift and it presses my lips against my teeth.
I wish mask frames were more leak proof
Make them shorter so they do not lay so high on the nose bridge. People like me with a short nose have a terrible time finding a mask that fits well - even the size small frames are too "tall".
Again, these need to be made smaller all over. The two I have both rest on my upper lip and have put a space between my front teeth.
Most hard shells are too big/wide for the female face. Care should be taken to accommodate the male and female differences. Also, why not use a vinyl type material that has some give in it rather than the hard , easy-to-break/crack plastic that is widely used now.
Most a too large a fit for my face
The frames slide around the air discharge holes sometimes.
Lightest weight possible.
Sizing; e.g. mask frames that are too large or too narrow.
It digs into my face and leaves big marks, but it has to be tight to stay on.
Find some way to cushion the mask portion that presses on the bridge of the nose.
If at all, make it softer!!!! The less hard stuff, the more comfortable.
My challenge is just getting it to stay put. I use a ResMed Activa and it is a bit heavy I think.
They're all too big! I've seriously thought about asking my RT for a pediatric mask. I have yet to find a nasal mask that truly fits well and stays in place well.
I think that a nice cloth covering over the plastic would be nice. I have personally taken a washcloth cut it up and have it put it over the mask, makes it more comfortable plus I us cloth on the head gear forehead where there is plastic that touches the head which has made it better.
Have them formed more to the face (flexible)
I need some distraction before falling asleep. Most nasal mask designs do not allow for one to wear glasses.
Curve it to fit nose and head shape, is that possible?
The hard plastic is not comfortable. It would be better if the plastic were in a softer form, flexible, and adjustable.
I wear a mask now that doesn't have a frame and it is the most suitable one I've found so far. I sleep on my face and the hard portions of the mask dig into my face.
Mask frames are all too hard and bulky
Make them softer and lighter and for WOMEN
Weight - The less mask and weight, the more comfortable for me. That is one of the best features of Respironics' old Simplicity nasal cushion mask, very little frame, the flexibility of the forehead/bridge of nose angle due to the headstraps rather than the plastic frame. I didn't find that the hard frame and the soft cushions added comfort, only weight. The edges of the thin outer cushion cover has every bit as much potential to cut into the skin as the simple nasal cushions.
Is there a way of making them a mesh? I don't see why they have to be solid. The also interfere with my glasses. Why does it have to come up by my eyes?
Make it a bit skinnier in the middle so I can see my book properly. The center area is just inside my line of vision.
Smaller, Smaller, Smaller. They stick out too far from the face. In my case they are too wide. I have a small face and the space between my cheeks tend to be smaller than others, I guess. The smaller the plastic frame the smaller the area of silicone gel, the less cheek under it therefore less leaks.
Tailor masks to fit women's smaller features. Measure thousands of women's faces so that you know how much difference there is between our faces and men's faces.
My nose gets red marks and I'm afraid this irritation will cause skin cancer. Make the nasal masks to fit only the tip of the nose.

What are your challenges with and suggestions for improvements with nasal mask cushions?

I think the cushions need more flexibility so that the size can be changed without fitting new cushions which is not easy
I love nasal cushions but again, they need to be closer together so one doesn't pop out while trying to seat the other. And if the actual hole is smaller then please make the pillow smaller too.
Better fit and seal around nasal bridge/eye areas.
Be sure that construction allows for non obstructed vision
I am using a daytime heavier cream on my face because I can't use it at night due to mask cushion sealing issues....BUT would rather be able to use it at night when it is most needed. My skin gets really dry at night....including my hands and lips.
Not small enough, make smaller sizes
The amount of space the mask cushions take up on my face, specifically between my nose and top lip. My nose gets pushed up uncomfortably sometimes.
Soft and supple but not floppy
Some have range of sizes, but not all. All should have options or sizes, and should provide multiple sizes in purchase with option (if size needed is known) to get more than one of same size.
Keep them as soft as possible. Sometimes it seems like they are digging into my cheek
For heavens sakes, make them smaller! Offer a much wider variety of sizes. Make the cushions softer and less irritating to the skin. Put some female engineers to the task, preferably engineers who have sleep apnea and have to use the equipment.
Somehow find a way to make the mask/gel one piece so that moisture doesn't get between then two.
The chin strap is bothersome, perhaps they can come up with something that better holds the cushions to the face.
Getting a firm seal
It's difficult for me to adjust the nasal mask just right, so that it doesn't get too tight around my nose. Perhaps adding a tiny cushion on each side of the nasal pillow would help, while still keeping the inflow of air secure.
I want them to be very soft like Gel
Make them to fit women! Lighter weight, softer material, softer strapping to fit a smaller woman's head
Find a way to round the edges of the thin outer cover over the soft cushions and the edges of the simple nasal cushions at the bridge of the nose and at the bottom of the nose.
I wish the cushions came out a bit easier for cleaning.
Leaks around where the cushions come in contact with the cheek are my main issue.
The cushions for the ResMed Mirage 2 are good, I get a great seal with it, so no changes.
It's very difficult to adjust so no air leaks

What are your challenges with and suggestions for improvements with nasal pillow masks?

The nasal holes are too far apart. I have to rubber band them together to pull them in.
Challenge is that I feel it changes the shape/size of my nose/nostrils with NA and Swift. Don't have a suggestion really although I would love to not have that problem.
Less "stuff" on the face, smaller straps, smaller pillows, smaller everything
Not only are our nostrils smaller but usually closer together...note that please.
The less on the face the better. There needs to be more choices in nasal prong/pillow type masks.
I use Mirage Swift now and used to prefer Nasal Aire. I felt like the NA made my nostrils larger and feel like the Swift has pushed my nose up changing the shape. I do tighten straps fairly good to keep good seal during the night. I do love my Swift though and sleep very well with it
Develop some kind of short term adhesive that doesn't irritate skin but helps keep nasal pillows in place all night.
Use softest material possible to lessen irritation of the nares
The nasal pillow masks I have been wearing put a lot of upward pressure on my nose, so I now have horizontal lines going across the top of my nose, between my eyes. These appear to be permanent -- an unhappy esthetic consequence of years of CPAP use.
Smaller sizes for women - not only nasal pillow inserts, but also the headgear
I use the Breeze headgear, and find it mashes my hair down against my head at the crown - wish there were more adjustments that kept the nose pillows in place but didn't press against my scalp. I like that it doesn't press against my face, though.
Make it smaller!
I have tried numerous nasal pillow masks. They are all uncomfortable. The only type of mask that is tolerable for me is the one (there is apparently only one) with nasal prongs...that fit inside the nose. I use the Nasal Aire II. The problem I have is with the tubing that is uncomfortable against my cheek to sleep on. I am a side sleeper. I am puzzled as to why there is only one nasal prong mask on the market...I can't be the only one who cannot tolerate the other types of masks. I wish I had suggestions for dealing with the tubing problem.
The pillows don't fit well into my nose. I hear hissing all the time, even though I don't think I am losing air.
I'd love to be able to use the nasal pillows, but can't because it seems to be impossible to keep my mouth closed when I sleep. The chin strap is not effective.
I love having different sizes - the DME does not always pick the correct size once you get home and start using your mask. Also, different angles of the holes might be good - or the ability to move the angles yourself (I seem to have one nostril that just isn't "normal" for the angle of my nasal pillow)
Same problem. The nasal pillows seem to all be designed for men. They're too large. Again a much wider range of sizes is needed.
The part that hooks to the hose is hard and somewhat inflexible, even though it has a swivel feature. When I turn over to my side, sometimes it doesn't swivel easily because it is rigid.
There needs to be more good options in these types of masks. Less contact with the face, especially the area being sealed off, is what people want and need in order to comply with their CPAP use.
Don't like nasal type, that air blowing is hard for me to adjust and settle my breathing.
My nose tends to get sore, and cold sometimes. I may be adjusting the nasal pillows too tight, or not tight enough. The headgear is such that after time, it stretches. Use headgear that does not stretch as easily with use, yet can allow the nasal pillow to be adjusted comfortably.
I am a side sleeper so I often wake up and have to adjust my nasal pillow mask because of it pushing against the pillow and becoming dislodged. Maybe the headgear should be softer near the nasal area, with the more rigid piece higher, near the cheek bone?
I don't like nasal pillow masks as I tend to sleep so they don't stay put and then I get drafts-I hate drafts.
Depends on the mask. The Opus does not fit me at all, the Swift leaks like crazy. I love the Breeze but the older version works better for me than the new version. I hate the adjustable tab for the straps. Need to develop more masks like the Breeze that don't touch the face.
Different sizes and the headgear too large
MAKE THEM SMALLER FOR WOMEN
I'm not a fan of nasal pillows and don't care for the more direct pressurized air into the nostrils.
Make it possible to choose a pillow size for each nostril. Not everyone has the nostrils which are the same size. Give me a way to secure the hose so it doesn't pull on one side.
I have not used one of these yet. I do have one on the way, I let you know if I get it in time.
I can not tolerate nasal pillows. They irritate the inside of my nose, no matter what size I use. This could be due to septoplasty I had. But I did try it.
Challenge is that I feel it changes the shape/size of my nose/nostrils with NA and Swift. Don't have a suggestion really although I would love to not have that problem.
I can't use these. I tried one and my nostrils got irritated.

What are your challenges with and suggestions for improvements with full face masks?

Keep out leaks all night -a big challenge
The headgear does not really fit properly-I have tried 3 different full face masks and the headgear for each one was made for a bigger head than I have. I have to overlap the straps.
I have only used a partial face mask, the Hybrid, and the material it was made from blistered my face. I loved the concept but again, the frame was too big even through there were sizes for the interface.
I can't find one that is comfortable and doesn't leak. I also break out from the latex.
Incorporate chin stabilizer to help with leaks around mouth
It seems that the mask places pressure on my teeth and are causing some shifting of my lower front teeth. Is there some dental appliance that could be worn to prevent this?
Tried the hybrid - too many leaks and the chin strap irritated my skin.
Frames are too long. Again my face length is to short for them to fit well and I would love to have one that fits because when I have a cold the traditional nasal mask is hard to use.
I realize bed time is not a beauty contest but if you wake up in the middle of the night and catch sight of yourself in the mirror, it is absolutely frightening! Why can't they come up with a delivery system similar to that of oxygen?
There needs to be a mask developed which will seal without causing pressure markings and sores on faces. This is especially important with those who must wear a full face mask at higher pressure settings. The goal should be to attain a good seal with less tightening of the headgear straps. There is a nasal type mask which was introduced about 2 years ago which practically floats on the face. The headgear straps on this mask must be loose in order for the mask to fit properly. Take this design and modify it as needed to produce a good fitting full face mask.
The three full face masks I have tried were made by different manufactures, and they were all big. I think they were made for only round faces and fat cheeks. I wear one with a small insert, it works-more or less. Of course my face stays red, and the bags under my eyes are a lot bigger now. Plus I am afraid the mask is hurting my eyes because the mask covers my nasal bridge plus part of the area under my eyes.
I haven't used the full face mask for many years. When I did use the full face mask, it wasn't very comfortable for me. However, I'm always open to trying any new, and improved full face mask, especially if it is recommended by another CPAP user.
I have a small nose bridge, which causes ongoing leakage by the eyes, when I pull the mask down to stop that leak, it leaks by my chin. I use a vpap machine with high settings, and find it impossible to get a seal without having to tighten the mask as much as possible.
Better seal like the ResMed Activa nasal
I still cannot find a full face mask that does not leak terribly in the nose bridge area
FF masks are nearly impossible to use when side sleeping due to frame being moved thus causing leaks and pain. Thank goodness for products like the PAPillow, otherwise I would have a tracheotomy by now
I never thought I had a small face until I was told I required a full face mask. I still cannot really find one that fits me - even the smallest sizes available are just not right. I have a short face and all of the frames are just too long. I struggle with nasal pillows and chin straps until the mask developers take us women more seriously.
MAKE A MASK THAT IS SPECIFICALLY FOR WOMEN
Shorter distance between bridge of nose and chin cleft. I don't find any type of pressure, width or weight, at the bridge of the nose comfortable. I find a mask fitting slightly below the bridge of the nose much more comfortable. Thus my preference for the ComfortLite 2 simple nasal cushion and the Simplicity simple nasal cushion.
I use a hybrid and would like to see more size options. Please remember that women's faces are different from men's. It would be nice to be able to find a mask designed for a woman's face.
Love the full face mask. I get a great seal, the old ResMed FFM was so easy to put on and get off, can do it in my sleep.
I use a full frame mask and have constant permanent red mark on bridge of nose, and the facial creasing does not fade for hours (I am under 30 years old)
Can't use full face mask - feel like I am suffocating and hyperventilating
I'd never wear one

What are your challenges with and suggestions for improvements with nasal mask forehead pads?

Too large. They stick to my forehead and become sweaty and sticky.
UGH!!!!! Do away with them!!!!!
Softness is needed
Make them easier to wash/disinfect. This is a common problem area for my skin to break out. Possibly removable or disposable covers.
Skin reactions to materials on face. Degradation of materials if moisturizers are used on face.
Thank goodness I don't have one on my OptiLife. They are the most uncomfortable things - and caused me to break out!
I like the silicone pads on the ResMed Activa
Make something that is flexible enough to conform to the forehead without massive buckles and suction cups.
Again, they seem to be designed for men. The forehead pad support needs to have a much wider range of motion in order to fit women. The pads themselves actually need to be replaceable, washable pads, not thin, pliable plastic material.
Masks overall need to be more compatible with skin, integrity, plastic against the skin for hours is not a good option.
Better padding... I get headaches if it is too tight but sometimes I have to have it tight to stop leakage.
The masks with forehead pads should not place undue pressure which causes pressure sores or permanent indentions. The mask should be designed so that the forehead pads ( if there need be any in the first place) are only there for balance and have minimal pressure contact.
Just make them softer, maybe some Gel pads where mask rests on the forehead.
Something soft that doesn't dig into my forehead.
Make forehead pads softer please
Forehead pads are just too heavy and push the skin down towards the nose and eyes causing wrinkles and irritation, lines and puffiness upon awakening.
Flexibility of the angle to the bridge of the nose. But I prefer the Simplicity LACK of the need for a forehead pad due to the headgear straps.
They do not hit in mid-forehead. Mine hits either too far up in the hair line or too low on my eyebrows. A middle ground would be better.
Leaves marks that last throughout the day, concern about causing/worsening wrinkles
Eliminate forehead pads altogether
Forehead pads cause me to have headaches
Can you make the length/placement of the forehead pads adjustable? This way I can place them where they will work best for me to get a seal.

What are your challenges with and suggestions for improvements with interface sizing options?

Should be easier to change, with one hand
We need trial periods so we can send them back. You cannot really know if a mask will fit unless you try it. Now I have an expensive new mask that I can not wear. What a waste.
The small distance between upper lip and eyes with women. I have a very difficult time keeping my mask from leaking into my eyes
I need a smaller interface, not just smaller components. Mine either blow into my eyes, cover my lip or just cruise all over my face.
Allow at least two sizes in each mask kit
Not enough range of choices
More ability for the patient to do their own sizing and interface angles. DME workers are not always able to figure the correct fit for each individual.
The bridge of my nose is to narrow for most of the masks and I have a problem with it leaking into my eyes. Much better since I changed to a ResMedActiva but still a bit of a problem.
Get more women into your testing facilities. Offer focus groups so we can tell you what we need. Take measurements of thousands of female faces. You'll find we're much different from men.
My face is unique. According to my dentist I should've had some kind of jaw work done when I was younger (it juts out too far), or something like that. So I suggest some type of flexibility to deal with various face structures.
Opus has enough variable bands so that sizing isn't a problem.
The best suggestion I can offer is to have the professional person who instructs you on CPAP use to size and fit you for the best mask for your needs and sleeping positions.
More sizes, more awareness that some faces are long and narrow, some noses are narrow, some are flat etc. etc.
There have been times when I liked the nasal pillows, but not the headgear. It would have been ideal if I could have kept using the same nasal pillows, but had a choice of a more comfortable headgear.
Take measurements and custom fit the mask.
Clothing sizes are different for men and women. CPAP mask sizes should be also. One size does not fit all or even most.
The ComfortLite 2 idea of adjusting the length of the down tube is one the right track - but it adds weight. Again, the Simplicity's manner with the Velcro and center headstrap is the better option for me.
Would like some sort of cheap sizing device (like they have for measuring nares sizes for nasal cushion masks) available...would rather pay $5-10 for that first than sink $200+ on a system where I'm trying to guess sizes based on measuring guides.
All the masks are so grossly over-priced! If they were a reasonable price, people would be able to buy several and experiment with them
I don't know how to size properly and don't know where to get help

What are your challenges with and suggestions for improvements with interface use instructions and packaging?

Ah, now here's something that can be improved. Putting the pieces together can be a challenge, so the directions have to be improved. Perhaps a larger "map" of how they're put together rather than a small diagram.
Package masks systems to allow patients the option to choose a headgear size petite, sm, med, large, xlarge as well as frame/cushion size petite, sm, med, large, xlarge.
Maybe the pieces can be color coded or numbered?
Make sure DME have sizing guides available for us
My home healthcare store never has masks I can try on - yet they will not let me return a mask if it does not work during night time sleep...how can we figure our what size we need?
Have pictures with step by step instructions.
All masks should come with several sizes of fittings for maximum comfort every night. My masks have had adequate instructions or I was able to find them on the web site.
Nothing works better than video Supply a cd/dvd or a web link so that user can view a demonstration
Actually, I love the DVD - it has helped on many occasions!
Better illustrations are needed. The illustrations need to be larger. Show me each piece separately, then show me how they all fit together.
The idea out there for video presentation is a good one. However, I believe having it fit by a professional is ideal. We should not have to purchase a pricey mask only to find out that it isn't comfortable or doesn't seal well once home and attempting to sleep with it. Then have to wait 3-12 months before our insurance will cover another mask!
I know that when I see a mask I might like I can't try it on because of sanitary issues. I also would like to see more brands of masks but my provider doesn't carry very many brands.
Provide pictures with patients actually wearing the masks in different sleeping positions. Most web sites only have pictures of the mask or the headgear. I want to see how they look on a face - not floating in midair. Come on people!
Larger font size on instruction manuals
Do NOT rely on the local DME supplier's to do a proper mask fitting! Too many of their RT's do NOT know how to do a PROPER mask fitting and too many are NOT supplied by the DME supplier w/the proper facilities to do a PROPER mask fitting. No place for the patient to lie down, no xPAP to set to the patient's pressure, no thought to the small tips such as running the fingertip along the"seam" between facial skin and cushion outer cover to eliminate small leaks, especially around the eyes, no suggestion to set the mask SLIGHTLY below the bridge of the nose, then lift the mask SLIGHTLY off the face and sliding it to where it SHOULD sit so that the edges of the cushion cover are turned under so they don't cut into the skin at the bridge of the nose.
I think it is pretty straight forward
Instructions are very clear to understand in my opinion.

Other comments you would like mask research and developers to know?

Women are not large children nor small men.
There are very few mask systems available that allow a comfortable fit and seal for those of us who sleep side to side or on our stomachs. I have to believe that most people do not sleep all night just on their backs. Actually, I would expect most physicians to advise their patients to stay off of their backs while sleeping.
Develop a mask where the exhaust air does not blow straight out from the front. The stream of air hits my husband and wakes him up causing me to have to set up some sort of "barrier" between our pillows.
Offer different sized headgear, not just different sized masks.
Offer masks for people on specific pressure ranges. For those of us on high pressure requirements, surely there are specific and better mask choices than for those on lower pressures. Make sure packaging shows pressure range preferences. If a mask is known to not work as well at certain pressures - make sure that is known on the packaging!
Our heads are smaller. There is a smaller distance between the top of our heads and our noses.
When women(or men) sleep on their sides or stomachs, their faces are having a lot of contact with the pillow or bed and cause masks to be displaced and leak.
Not to have a one size fits all. I happen to have a small head
Have women that actually use Cpap work on the development and design and use them out for a few weeks when sleeping.
Mainly, women's faces aren't just smaller but can be shaped differently. I find mine is wide enough but too long. If mask frame is poking at my eyes I can't move it down as it's already on my upper lip. Even when I can get the seal part set comfortably, the solid part of the mask extends too far.
I could never had made any mask work if I did not use a PAPillow. Side and stomach sleepers have real challenges with mask leak and frame soreness issues.
I want to put cream on my face at night. Make an interface that will make it possible.
That one size doesn't fit all. More masks designed for people with petite features.
Not everyone sleeps in one position all night. I move around a lot at night due to degenerative disc disease, and arthritis. My mask pulls loose when I change position because the tubing tugs at it, waking me up. I find it hard to continue using it since I can not go back to sleep after a couple times of the mask/tube issue. This is why I wonder if I will be able to tolerate it for the rest of my life. I have lost 35 pound so far in hope that I will someday not need the APAP. My family feels that I am actually losing sleep since it is so disruptive to my sleep.
My face is being wrinkled excessively (cheeks, between eyes and forehead) from the straps and mask frame. Night time facial moisturizers are must for a lot of women including myself to help with the aging process. To have a mask that would allow this without compromising the seal and the wear time of the mask would be great.
Strap marks on both cheeks are hard to deal with. I feel my skin below the lower eye lids has stretched and made me look much older since using CPAP. I inquired about plastic surgery w/primary care physician but she just brushed this concern off. If I must wear the CPAP I feel the damage to my skin should have some consideration. This is a serious issue that should have been discussed at my diagnosis as possible outcome of cpap mask use.
Tubes that go over and then behind the head are better than tubes that drape over the body because it's important that the wearer be able to turn in bed WITHOUT WORRYING that he or she might disrupt the machine
Remember that women use the products too. We have smaller facial features than men and softer skin too.
The most important thing is comfort, comfort, comfort! The fewer the straps on my face the better. Any straps should have comfort wraps like we now have to buy as additional gear.
Headgear should not pull hair (in other words, no rubber) Headgear should be fully adjustable and account for women's smaller heads.
Masks that vent downward make me cold.
Being able to wear glasses with the mask is important to me.
I would like masks and machines to be as quiet as possible.
Make them user friendly, sized to fit, remembering women use night creams so disposable sleeves for straps would be good and is it too much to request pastel?
To come up with a mask material that will not break me out or irritate my skin
Too many cpap users find therapy ineffective and stop nightly use! If more users could avoid mouth leaks, they might experience better results!
Sure, everyone wants a minimal, easy-to-use mask but, unless mouth and nose are covered, the cpap air easily becomes diverted as the user attains deep sleep. Chin straps do not hold air from escaping mouth! Mouth taping is not recommended! So, how about give cpap users more mask options like the Hybrid and Liberty!
Need softer hoses. The exhaust valve makes loud noises when inadvertently blocked by bed covers, and this wakes me up. Could the valve be guarded?
I tie a band around my waist and clip the hose to it so that it will be stable all night. Clipping the hose to a moving/movable night gown is not sufficient.
I have to use a chin strap because otherwise my mouth opens during the night and I don't get the air I need. It would be nice if the chin strap could be somehow built into the rest of the apparatus.
Keep trying to build a mask that is not so cumbersome and perhaps has a bit more flexibility without compromising potential leakage.
Give us the chance to do our own sizing - give us the options - remember not everyone fits into S,M,L! 1/2 sizes, or even a mask that can be molded to the face (hmmm... I would pay extra for that!).
I really would like better fitting head gear.
Please include more women engineers on your teams. Be sure at least one-third of your engineers, both women and men, are actual CPAP users.
Include more CPAP users in your mask testing. I've been on CPAP for 7 years, and never once have I been approached by a CPAP mask manufacturer for an opinion.
Include a postage-paid comment sheet in your mask packaging that will be sent directly to your company. Use all of the above questions - they're excellent!
Allow a client more opportunity to trial the different masks to determine the best fit/type/style of mask. I think there would be more compliance if more of a timeframe and ability to change masks as needed were an option.
Develop other sizes for women.
It would be nice to have a mask that doesn't leak at high pressures. My APAP goes up to pressure 20 (I was titrated at 16).
Work with making the cushioning more comfortable.
I have used a CPAP now for 8 years and am amazed to find very little design change. I would highly recommend that people who have been using masks for a long period of time be able to have some input into the design of a mask which they would find to be better. When a new mask is introduced, I can pretty well tell how well it will work for the majority of COMPLIANT CPAP users. Think outside of the box!
I became a new person when I got my CPAP machine. Life was fun to live again. Therefore I will put up with inconveniences more than some. I like the soft gel mask, in fact can't sleep without it now!
I was diagnosed 7 months ago, I needed a full face mask and discovered there were few choices and it is almost impossible to find one that does not leak, hurt your nose or eyes. I would have thrown the whole thing out the window, if I did not have such a problem with my oxygen going too low. Also it brought my blood pressure under control.
Thank you for your all efforts to make masks in such a way, that it is less of a challenge, and more of a comfort for CPAP users. Your efforts towards making CPAP equipment more comfortable will result in more patients willing to use the CPAP.
The masks that I have bought to try out (4 varieties) all have problems with the seal holding. Is this from the pressure (20/14) of the bipap levels. Is there a mask that is built to withstand unsealing at that pressure?
Make sure patients test products
Masks are just too big and too heavy
Please make and market a line that is strictly for women - WOMEN FRIENDLY
Lighter weight, more flexible materials. Keep in mind the various pressures. Many are on CPAP at lower pressures such as 8 cms and yet others are at higher pressures such at 18 cms. Some masks work better at the lower pressures, and some masks seem to NEED the higher pressures to properly "inflate" for comfort. A recommendation based on trials of whether a particular mask works better at higher or lower pressures would help.
More Petite sizes are needed for women. I'm not a large woman by any means, but neither am I some petite little princess. I'm 5'4" and 115 lbs. But finding a small enough mask can be a challenge.
If they could find a way to have it stay on my face without all the headgear... I love my machine and it means that I am human again so I will use it no matter what. But I would like it to not be so cumbersome. I unhooked the hose rather than re-shift the headgear to go to the bathroom and scared the heck out of my roomie.
I am looking for a mask that comes in contact with the face and head as little as possible. If it does come in contact with the face a material that breaths and allows the skin below it to breath would be wonderful. My pores would really appreciate being able to breath at night. Is there a way to make a mask stay on and just hold onto the head like a pair of glasses, just hook behind the ears? That would help a lot. Keep in mind there are women and I assume men out there who have small noses and mouths, therefore small faces. We have a hard time finding masks that are comfortable and compatible with our faces. Therefore gives us more challenges to overcome.
Masks are grossly overpriced! We are at their mercy though, if we don't use CPAP we are at serious risk for stroke, heart attack, or death. The masks look like they would be VERY cheap to mass produce.
Avoid the "Darth Vador" look!
Please make a mask with no straps going over my cheeks. I like the idea of the Comfortlite 2, but with less on my head. Also make more sizes in the simple cushion.
My mask makes my complexion ruddy and i worry that it is ageing me prematurely by putting pressure on my face and causing wrinkles.
Not a mask issue, but how about disposable hoses so that you would not have to constantly clean them.
Make interfaces less medical looking - I feel so ugly wearing them.