I have used nasal pillows since my first night on CPAP, more than fifteen years ago. In all that time I have changed machines once. The small parts, though, get swapped out constantly.
Most people do not replace them anywhere near often enough. Not because they are careless, but because nobody ever handed them a schedule. The parts wear out quietly. A cushion does not crack in half. It just gets a little softer every week until it stops sealing, and you start waking up tired again without knowing why.
Here is the schedule, what each part does when it fails, and how to tell without counting days.
The schedule Medicare follows
Medicare sets how often it will pay for each part. Most private insurers copy it closely, so this is a fair guide even if you are not on Medicare.
- Mask frame: every 3 months
- Nasal cushions or nasal pillows: 2 per month
- Full face mask cushion: 1 per month
- Headgear (the straps): every 6 months
- Chin strap: every 6 months
- Tubing or hose: every 3 months
- Disposable filters: 2 per month
- Reusable filters: every 6 months
- Humidifier water chamber: every 6 months
- The machine itself: every 5 years
Your own plan may differ. Ask your supplier to confirm what yours allows before you order, because that one question saves a lot of surprise bills.
What actually goes wrong with each part
Knowing why the schedule exists makes it much easier to stick to.
Cushions and nasal pillows
These touch your skin all night, every night. Silicone absorbs facial oils and slowly loses its shape. A worn cushion stops gripping, so air escapes around the edge.
That leak does two things. It drops the pressure keeping your airway open, which is the whole point of the therapy. It also blows air across your face or into your eyes, which wakes you up.
If you are tightening your straps to stop a leak, the cushion is done. Tighter straps are not the fix. They just press the worn cushion harder against your face and leave marks.
The mask frame
The frame is the plastic part that holds everything together. It lasts longer than the cushion, but the clips and joints loosen over time. A frame that will not hold its adjustment overnight needs replacing.
Headgear
Straps stretch. A stretched strap cannot hold a good seal no matter how far you pull it. If your headgear is on its tightest setting and still slipping, it is stretched out.
Tubing
Hoses develop small cracks and pinholes, usually near the ends where they bend most. A cracked hose leaks pressure all night, and you will rarely hear it.
Look at the cuffs at each end. That is where they go first.
Filters
The filter protects the motor and your lungs from dust. A clogged filter makes the machine work harder and pushes dusty air at your face.
Hold a disposable filter up to a light. If it looks gray instead of white, change it.
The water chamber
Mineral deposits build up in the tank, and those minerals are very hard to clean out once they set. A cloudy or filmy chamber should be replaced rather than scrubbed.
Use distilled water, not tap water. This is the single easiest thing you can do to make a chamber last. Tap water carries dissolved minerals, mostly calcium and magnesium, and every drop leaves a little behind when it evaporates. That is the white crust you see in the bottom of the tank.
Distilled water has had those minerals removed, so there is almost nothing left to build up. A chamber run on distilled water stays clear far longer, and it is easier to rinse clean.
Hard water areas are the worst for this. If your kettle at home furs up quickly, your water chamber will too.
You can buy distilled water by the gallon at most grocery stores and pharmacies for a couple of dollars. Do not substitute filtered, bottled, or boiled water. A filter jug improves the taste but leaves most of the minerals in place, and boiling actually concentrates them.
How to tell without a calendar
The schedule is a floor, not a rule. Your parts may wear faster. These are the signals worth watching:
- You wake up with dry eyes, or air blowing on your face
- Red marks on your skin that stay for more than an hour after waking
- You have tightened the straps more than once in a month
- Your machine reports higher leak numbers than it used to
- The cushion feels tacky or slippery rather than smooth
- You are tired again, and nothing else in your routine changed
That last one matters most. Worn supplies are one of the most common reasons therapy quietly stops working after a good stretch.
What it costs
Under Medicare Part B, you pay a yearly deductible first, which is $283 in 2026. After that Medicare pays 80% of the approved cost of your supplies, and you pay the remaining 20%.
Ordering more often than the schedule allows means paying the full price yourself. That is worth knowing before you call, because a worn cushion two weeks early is still your own expense.
If you have a supplemental plan, it may pick up part of that 20%. Your supplier can tell you what you will actually owe before they ship anything.
Set it up once, then stop thinking about it
Almost every supplier offers a resupply program. You give them your schedule once, and they contact you when you are due. Some ship automatically, some call or email first.
Take the version that asks you first. Automatic shipments are the ones people forget about. A forgotten shipment is how you end up with a surprise bill and a box of parts you did not need.
If your current supplier does not offer this, that alone is a good reason to look at another one. It is a basic service, and plenty of suppliers do it well.
Your next step
Go and look at your cushion right now, before tonight. Press it with your thumb. If it does not spring back, or if it feels tacky rather than smooth, it needs replacing.
Then call your supplier and ask two questions. What does my plan allow, and can you set me up on a resupply reminder?
If you do not have a supplier you trust, find one near you on CPAPLocator and start there.
*CPAPLocator.com is a directory service only. We are not a medical provider. Content is for informational purposes only. Always consult your healthcare provider.*