The interface in home non-invasive ventilation: is the nasal mask better?

The choice of mask is a very important step in the management of sleep disordered breathing, in which most research is concerning patients with obstructive sleep apnoea (OSA). Compared to the very heavy, custom-made masks used in the early days of continuous positive airway pressure (CPAP) treatment for OSA [1], the technology regarding design and lightness of these masks has improved considerably. Optimal fit of the mask is essential to avoid leaks and improve acceptance of CPAP treatment, especially when auto-titrating machines are used in OSA patients [2]. A recent bench study analysed the response of three widely used CPAP devices to test their effectiveness in compensating for leaks, with variable results [3].