ResMed Mirage Quattro add these liners or dump it?

[vince32837]

Hi-

I'm new to CPAP,

My doc required 2 sleep studies. After study #2, said I needed straight CPAP pressure of 16...my AHI was 41 ( pretty high)
refused to give Rx for Resmed S9 autoset, said data only supported straight CPAP.

So I got the S9 elite, but it was a fight, they wanted me to take the escape they cant sell..

In the clinician mode- they set me up for 30 min ramp starting at 12..then end up at 16 pressure.

I have 2 issues:

Issue 1: older Resmed Quattro was used at the sleep center, and is highly regarded full face mask...They told me its the gold standard for high pressure mouth breathing people. I am getting the red marks on nose bride pretty bad, looked at other posts, put bandaids did not work makes uglier red mark...what about those Remzzz liners will that stop it...mask is not too tight , I have it just at the point where leaking stops!

Is there a quality alternative mask to the Quattro, that leaves no facial marks for high pressure mouth breathers or get the liners...(DME says I have 30 days to be happy or exchange)
side note- at the DME store, I tried blue gel mask at a 12 pressure , it was very comfortable to wear, but it was so hard to exhale, I picked the Quattro????????????

Issue 2: The Quattro mirage mask really leaks lot of air out the exhale port, is that normal???? I see inside a white transparent plastic flat panel piece inside, but lying down at press of 12-16 you put your hand over the exhale port see arrow, there is strong flow of air.. is that right???

http://s201.photobucket.com/user/vince3 ... sort=1&o=0

frustrated looking for guidance,

Thanks Vince
vince32837

Posts: 1
Joined: Sat Feb 08, 2014 10:17 am

[LSAT]

Go to padacheek.com and look at mask liners and nose pads for the Quattro.

The Quattro exhale port does send out lots of air...that is intentional to get rid of the O2....Don't block it.

[vince32837]

Thanks LSAT...
Vince

[library lady]

I am new to CPAP also; been fighting with my Quattro Air mask all week; it leaks like crazy, and yesterday I got some RemZzzz liners. Overnight they have made all the difference in the world of sleep for me! I don't know if they'll fix your red marks or not, but they will take care of your leaks. I did order PadaCheeks, but I was so desperate for sleep yesterday that I got the liners anyway. RemZzzz are disposable, one time use but the PadaCheeks are washable and can be reused so ultimately a better option but like many other things, will wear out over time but better for the environment, I should think. Good luck!

[Denial Dave]

My padacheek liners lasted 13 months before I needed to replace them. I probably could have made them last longer if I were crafty.

[Sir NoddinOff]

In my experience, Remzzz start to leak around 16 to 18cmH20... unlike Padacheek liners, which are made of heavier material. Padacheek just seems to hold up to higher pressure better IMO. That being said, it can't hurt to try Remzzz since you can get a free week's sample if you go to their website... however, you have to pay postage and handling. I've found you can use the same Remzzz liner for about four nights if you keep the same side to your face every night. For the short period I tried them, I marked mine with a Sharpie pen to make it easy. Be sure to wash your face at night before using Remzzz - same with Padacheek liners.

There are several popular options to the Quattro line, just go to CPAP.com to check them all out. It all depends on your technique, your face and your pressure - every person and every mask is different so it generally takes some testing to figure out what's right for you.

[vince32837]

Wow! fast tips thank you..nice forum

I will buy both the Remzzz and PadaCheeks liner...leaking has not been an issue, other than the exhale port like tea pot flow...

Thanks Vince

[Julie]

I don't know your machine well but most decent ones these days have a feature called EPR which you can set to allow easier exhaling... check if your has that.

[xyz]

> refused to give Rx for Resmed S9 autoset, said data only supported straight CPAP.

It's difficult to believe that that is actually medically true.

> they wanted me to take the escape they can't sell.

Ah, there's the answer. In some states it's against the law for a doctor to refer a patient to their own "facility". Your case is exactly why that law exists.

They're pawning a cheap cpap machine off on you.

Fire that doctor.

Any of your doctors can write a prescription for a machine, it doesn't have to be a sleep doctor. Be sure that the DME you choose is in-network. Get prior auth and a firm cost estimate in writing/email.

Be sure to get a good machine -- auto, heated humidifier, _full_ data capablity.

Back to your main point.

> The Quattro mirage mask really leaks lot of air out the exhale port, is that normal?

At that (constant) pressure, yes.

> at the DME store, I tried blue gel mask at a 12 pressure,
> it was very comfortable to wear, but it was so hard to exhale

Well, that's _C_pap for you. That's why my initial response focused on the brick they pawned off on you. That was, at a minimum, unethical and depending on the state you're in, illegal.

The reason my reply focused on the machine, not the mask, is that the problems that you are having with the mask are a _symptom_. The (high fixed pressure) machine is the cause.

> said I needed straight CPAP pressure of 16

That is called the "90% figure". It's supposed to address 90% of the SA events.

The problem with a _C_pap set at a fixed 90% number is that 89% of your events can be solved with a lesser pressure. Which means fewer leaks and more comfort.

An apap only uses 12 (or whatever, for example) at the times that you only need 12. Which is more often than when you need 16.

See what you can do to replace that machine.

[vince32837]

XYZ-

Thanks for the advice....

I think I'm going to push to exchange S9 elite for an autoset...
elite is a nice machine no question, but like to have that vary press. mode...

V

[markdh]

My padacheek liners lasted 13 months before I needed to replace them. I probably could have made them last longer if I were crafty.

I've bought the padacheek liners, but the opening for my mouth/nose is so small I find them to be useless. I realize that it can be trimmed, but I find cutting the fabric cleanly difficult. Am I missing something obvious?

The opening for the RemZzzz is huge in comparison, but when I wear them the mask tends to slide up my face and off of my mouth.

[chunkyfrog]

Vince, at 16cm pressure, I would push for a Bipap.

[Snorman]

I've used both the Remzzz's and the Pad-a-cheek, and for me, there seems to be less leakage with the Remzzz's. That being said, I still have a lot of leaks which keep me from falling asleep. I have my ramp to go from 7 to 14 within a half hour, and the leaks become noticeable toward the end of that period. I'm pretty frustrated right now.

[mellabella]

If you continue to have trouble at a straight 16, seriously consider pushing for a trial of a BiPap, from one who's been there (and had a pulmonologist recommend it). For what it's worth, the Hybrid works for me at my high BiPap pressure (see below) but it's not a good fit (literally) for everyone so see if you can borrow/trial/use return insurance for one instead of committing. It solved the leaks and sores and swollen lids the Quattro caused, given my face anatomy, and I get beautifully straight leak lines, but some people just hate it:

[sleepy711]

First, quickly take the straight pressure machine back and have it traded out for an auto. Be assertive and tell them, if they want to sell you a machine, they will get the auto. You can get one somewhere else. Be prepared to walk out. I assure you, they will not want you to leave without a machine. A straight pressure can be set on the auto while you work out getting a prescription for an auto setting. After a certain period of time in rental, the machine will go to purchase and you could end up getting stuck with a machine you don't want.

Second, many people require a range of pressures throughout the night depending on the position of sleep they are in, stage of sleep or simply require higher pressures toward the end of the night. Chances are, you only need 16 for 20-25% of the night. A variable machine allows for less pressures therefore less mask leaks.

Much of this information is available in "My Little CPAP Book" for iTunes and Kindle.