Mask-related complications occur with greater frequency the longer the patient is on NIV ventilation or CPAP therapy, which often leads to escalation procedures. The use of ventilation helmets offers a patient-friendly alternative in these cases, which can help avoid intubation and reduce lethality. Helmet therapy can also be used as a preventive approach for avoiding mask-related problems and allows for the safe application of higher PEEP levels. It is well accepted by patients as a supplementary therapy option, since helmet applications significantly reduce eye irritation and stomach bloating. To avoid any undesired CO2 rebreathing, it is best to use ventilation helmets with adaptable byflow or high-flow CPAP systems with adjustable flush flow.