Participant Identification

First Name *

Last Name *

Usage Duration

How long did you use the CPAP mask last night?

More than 6 hours

4 – 6 hours

2 – 4 hours

Less than 2 hours

Air Leaks

Did you experience air leaks?

No noticeable leaks

Minor leaks, did not affect sleep

Moderate leaks requiring adjustment

Significant leaks affecting sleep

Comfort

How comfortable was the mask last night compared to your previous mask?

Mask Stability

How stable was the mask during sleep compared to your previous mask?

Skin Irritation or Pressure Marks:

Did you notice any skin irritation or pressure marks after use?

No

Yes, mild redness

Yes, moderate discomfort

Yes, severe irritation

Sleep Quality

Additional Comments

Please provide any additional comments or suggestions:

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