Sleep Therapy

Sleep Therapy Compliance: The Mask Matters Most

The most significant component of adherence, from a device perspective, is the mask, and technological advancements and patient-centric mask solutions, optimized for specific DME business models, are driving new ways to improve patient compliance rates and successful business outcomes.

The sleep industry continues to face challenges in increasing compliance and long-term adherence of patients to PAP therapy. Where low levels of compliance are concerning, it also presents a massive opportunity for DME providers and device manufacturers. Long-term adherent patients not only benefit from improved health outcomes but also drive sustainable revenue opportunities for DME providers.

The components of a typical setup, which influence therapy adherence, are the CPAP machine, breathing mask, educational support, and patient behavioral factors. The most significant of all these, from a device perspective, is the mask. Technological advancements and patient-centric mask solutions, optimized for specific DME business models, are driving new ways to improve patient adherence rates and successful business outcomes.

Since the mask is in contact with the patient’s face, it requires carefully designed features to comply with a wide range of facial dimensions and geometries. It needs daily care plus adjustments to minimize leaks. If not set up properly, the mask leaks could cause discomfort and result in poor adherence. The usability of PAP hinges heavily on the patient’s perception of the mask, as it’s the most patient-dependent component of the whole setup.


Masktechnologies have evolved a lot over time. Masks are now designed with advanced engineering materials using state-of-the-art automated manufacturing processes which integrate materials into very intricate shapes. As an example, F&P Simplus was the pioneer in using silicone in an intelligent way to reduce pressure on the bridge of the nose and also to achieve leakproof sealing capability up to very high CPAP / BiPAP pressures.

Use of patient-centric product design methodologies with extensive use of data and product-use testing has driven the quality of masks to meet the very demanding patient compliance and comfort requirements with optimal size and shapes. Nasal pillows can gently minimize irritation in the nostrils.

State-of-the-art manufacturing techniques drive the quality of masks, especially to meet the very demanding usability expectations of patients. Headgear that holds its shape to make them easier to wear has now become available. Users can put on this headgear with one easy, single-handed movement and with their eyes closed — just like putting on a baseball hat.


Appropriately selecting the correct/optimal size of cushion and headgear also drives compliance, as a wrong-sized cushion can lead to unintentional leaks and cause a number of cascading issues such as dry eyes, skin irritation, etc.

Several new software apps are being developed to assess the appropriate size. A more robust approach to the size challenge, however, especially when setting up a new patient, is to go with a trusted and proven low-tech solution which includes multiple sizes in one pack.

Kits that offer multiple sizes of cushions in one single package and include very simple and intuitive patient instructions, such as F&P Fit Packs, enable the patients to identify the optimal size of cushion appropriate for their individual needs. This also encourages patient involvement in the process and develops patient engagement with the therapy, and helps them solve problems and become selfreliant, which is extremely important for long-term adherence.


CPAP therapy can be overwhelming for new patients, and resolving issues in a timely way can make or break a patient’s confidence and motivation to stay on therapy long-term.

Education and support are two of the most important factors to consider. DME-based respiratory therapists play a significant role in imparting the required education and guidance. However, Software tools, especially mask-focused smartphone apps are also playing a significant role in helping the patients.

On-demand help at patients’ fingertips is an important solution consideration for DMEs. Apps such as F&P myMask App are gaining momentum and could play a transformative role in making patients self-sufficient in troubleshooting routine issues.


  • Mask matters the most in steering patient perception and compliance
  • Mask technology features play a role in driving long-term adherence.
  • Enable patients to become more self-reliant in sizing their cushions, troubleshooting routine mask issues, and understanding how to use and clean their masks by providing on-demand help on their smartphones.


To read more articles and features about therapy, visit hme-business. com/sleep. To learn more about Fisher & Paykel Healthcare’s sleep therapy solutions, visit or

About the Author

Subbarao Potharaju ( is the director of marketing for Fisher & Paykel Healthcare. He has led a number of CPAP product development projects during his 24-year career with FPH in New Zealand and the United States. He currently heads the Product Management, Marketing and Software Support functions for FPH’s North American Homecare business.

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