New user w/ Mirage Quattro and leak problem.

[Basher]

So first off, I was recently diagnosed with Severe OSA. Because of this I was instructed to use a CPAP. After visiting with the DME, I was given a ResMed S9 Elite. It is currently set at 10 cm and I am going through the ResMed H5i humidifier with Climate Control.

Because I am a "mouth breather", I was given a Mirage Quattro full face mask. The problem is that once the pressure ramps up to 10cm, the mask begins to leak like a sieve. So in an attempt to counteract this, I disabled the Ramp feature and allowed the CPAP to start off at the full pressure, so I could adjust to fix any leaks. This seemed to work at first, but later in the night, the mask started leaking again and ended with me taking the mask off and going back to sleep.

I have tried tightening the headgear and using the knob at the bridge to fix the small leaks, but it always ends with me giving up.

Maybe it's because I end up shifting to my side during the night? Do I need to force myself to sleep on my back?

Any insight would be appreciated.

Thank you.

[jennmary]

I have used the quattro. I actually still use it when I have a cold. I trained myself out of mouth breathing and now use a Swift. Anyway....back sleeping is not a great idea. You have more apneas in that position. I would recommend you put on the mask, then lay on your side and do any adjustments. A mask can fit great in one position then have nothing but problems in another. So it should be adjusted in the position you actually sleep in.....at least that works for me.

I wish I had better advice.

[elader]

I am a mouth breather and wandered through the land of nasal masks until I ended up with the quattro. First, don't sleep on your back. Shove a ball under the back of your shirt if you have to. Apnea is worse on your on your back and your mask will leak more because the shape of your face changes when your chin drops back. I position my self on my side with my face well supported but with the mask NOT resting on the pillow. I also have this weird habit of sleeping with a light pillow over the other side of my face in a 'face sandwich'. I wiggle the mask down into position so it's not pushing on the pillow. I find the knob adjustment to be critical in avoiding leaks. Don't cinch the straps so tight that it hurts - it doesn't help things and may actually cause leaks because you deform the gasket. Finally, you should find a provider that lets you try on a bunch of masks. Maybe the shape of your face isn't compatible with this mask. How does the mask FEEL when you have it on - does it feel like it fits?

So first off, I was recently diagnosed with Severe OSA. Because of this I was instructed to use a CPAP. After visiting with the DME, I was given a ResMed S9 Elite. It is currently set at 10 cm and I am going through the ResMed H5i humidifier with Climate Control.

Because I am a "mouth breather", I was given a Mirage Quattro full face mask. The problem is that once the pressure ramps up to 10cm, the mask begins to leak like a sieve. So in an attempt to counteract this, I disabled the Ramp feature and allowed the CPAP to start off at the full pressure, so I could adjust to fix any leaks. This seemed to work at first, but later in the night, the mask started leaking again and ended with me taking the mask off and going back to sleep.

I have tried tightening the headgear and using the knob at the bridge to fix the small leaks, but it always ends with me giving up.

Maybe it's because I end up shifting to my side during the night? Do I need to force myself to sleep on my back?

Any insight would be appreciated.

Thank you.

[echo]

Welcome to the forum!

I agree with Elader - get your provider to let you try different FFMs, your face shape may just not be suitable for the Quattro (or it's the wrong size). When you try them on, make sure you test them with a cpap set to your pressure, and test it lying down.

In the meantime you can also try Macks Silicone Ear Plugs to plug up the known leaks. Even if it doesn't work in the end at least then you'll be able to say been-there done-that!

[DoriC]

Welcome! The right bed pillow is important especially for side sleepers with FF masks. Do a Search here and you'll get lots of good info. My husband alternates between a SleePaPillow which you can purchase at cpap.com and the Regeneris pillow by PurSleep. Good luck.

[PST]

Hi Basher. I'm a full time Quattro user and pretty much a Quattro leak success story at a pressure of 15. (Never got over the leaks at 17, but fortunately my titration study resulted in a lowering of my prescribed pressure.) I totally agree with the other posters that about trying not to sleep on your back. Pillows are important, and I would say that there are two pillow theories, both of which work for some and fail for others. The first is pillows that more or less don't touch the mask. There are different kinds, some of which rely on using the edge or an indentation so the head is supported but the mask isn't pushed around. The second school of thought, to which I belong, is that with a big, fluffy "side sleep" pillow, the pillow actually helps gently press the mask to the face. A side sleep pillow (see the Bed Bath & Beyond catalogue) is too thick for comfortable back sleep, but the right thickness for sleeping on one's side (duh!) without folding or doubling up pillows. I find if I just kind of nuzzle into it with my head turned slightly down into the pillow, it helps keep everything together comfortably and with little leakage.

Further advice, again based on what works for me but not for everybody necessarily, is strap technique. I find that with pretty tight bottom straps but fairly loose upper, the mask floats pneumatically on the cushion and the air pressure inside helps seal it to my face. Keeping the face and, more importantly, the seal free of skin oils is crucial. I hate taking two or three minutes to wash the cushion before bed, but it helps a lot. Figure out the dial setting that just barely keeps the hard parts of the mask from touching the nose, then don't let anyone adjust it.

Good luck.

[plr66]

You can see clearly that this mask experimentation is a very individual thing. So all suggestions should help you in your quest. The one constant is the recommendation to not sleep on your back. Bed pillows can make a huge difference in leak problems. I tend to do like PST above, by sort of wedging my mask into the pillow just a tad while lying on my side. I mostly use a PaPillow, with my mask mostly off the side of the pillow. Just be sure the CO2 vent is clear of the pillow.
And about the cleaning of facial oils from the mask cushion---well you might want to at least look at this link, as I was truly amazed. viewtopic.php?f=1&t=49416&st=0&sk=t&sd=a. I also adjust my mask fairly snug on the bottom straps, but not so tight that the cushion is flattened to point of the hard frame touching my face. Despite getting my mask leak-free when I go to bed, I find that I usually wake up about 1-2X per night with a really minor leak going on. Just a slight twist of the bridge button fixes that, and I'm off to sleep again. Be patient, and try everything for a few nights to see what works for just you.

PS--Elader, welcome back! Been a long time since we've "seen" you.

[LSAT]

Count me in on the Quattro adjustment mentioned by PST and plr66. I also tighten the bottom and let the top float. If I feel a leak in my eyes I manually tuck it in at the top of my nose.

[PST]

Count me in on the Quattro adjustment mentioned by PST and plr66.

And you can't argue with two princes and a frog.

[RipVW]

Hello & Welcome, Basher! Glad you found this forum—SO much useful info and everyone here is so willing to help!

You're lucky to have found this forum as you begin CPAP—took me almost year before I found this place and, with the help of folks here, got my CPAP therapy working as it should. Many of us had similar problems getting the mask adjusted at first—note, too, that loosening the straps sometimes does the trick. The mask cushion needs to “hover” a bit rather than being pressed tightly against your face. And, sometimes it is a matter of finding the right mask that fits one’s face best. For me, it is the Resmed Ultra Mirage FFM—the Quattro just never worked for me. It does take time to get everything tweaked and working at its best, so patience is key as one begins CPAP.

"You are getting sleepy . . ."

[plr66]

Count me in on the Quattro adjustment mentioned by PST and plr66.

And you can't argue with two princes and a frog.

Now that's funny!

[RoninHouston]

Have used the Quattro for the last two months, my only mask. Make sure when you think you had a major leak during the night, check your CPAP numbers to verify it. Found when I thought I had major leaks the data did not consider it a major leak. That said you have been given some good advice on wearing and adjusting the Quattro.

I found a properly adjusted forehead dial will keep the mask from pressing my nose bridge along with loosing up on the top straps. The mask should float on your face like an air cushion rather than strapped so tight as to press against it. This mask needs to be adjusted with pressure to activate the cushion effect. Also if the mask is too high on your nose it may/will press your nose bridge.

PST is right, most of us have found a pillow that works. I like the Contour CPAP because it has a space for the mask while supporting your head and neck on my sides. It allows me to sleep on my sides with a minimum of leakage.

[Wulfman]

So first off, I was recently diagnosed with Severe OSA. Because of this I was instructed to use a CPAP. After visiting with the DME, I was given a ResMed S9 Elite. It is currently set at 10 cm and I am going through the ResMed H5i humidifier with Climate Control.

Because I am a "mouth breather", I was given a Mirage Quattro full face mask. The problem is that once the pressure ramps up to 10cm, the mask begins to leak like a sieve. So in an attempt to counteract this, I disabled the Ramp feature and allowed the CPAP to start off at the full pressure, so I could adjust to fix any leaks. This seemed to work at first, but later in the night, the mask started leaking again and ended with me taking the mask off and going back to sleep.

I have tried tightening the headgear and using the knob at the bridge to fix the small leaks, but it always ends with me giving up.

Maybe it's because I end up shifting to my side during the night? Do I need to force myself to sleep on my back?

Any insight would be appreciated.

Thank you.

WHERE is it leaking?
Some of the earlier Quattro masks leaked around the elbow in the front of the masks and it was hard to tell where they were leaking. If you happened to get one of those older ones......maybe that had been on a DME shelf or a couple of years, it's possible. If it IS leaking there, pull the elbow out of the front of the mask and make several wraps around it with some plumber's Teflon tape. It's been quite some time since anyone has had that problem, but I guess it's possible.

Good idea to disable the Ramp.

With the adjusting knob.......I turned mine all the way to the right to bring the forehead support as far forward as possible. That allows the seal to get closer to the upper part of the nose bridge. Then, loosen the upper straps.
If you're using a "standard" bed pillow, they can push the mask around and cause leaking if your head sinks into it too much.
There are pillows that are designed for (or work better with) CPAP therapy. You might want to look into one of those. I use a "Chiroflow" water-based pillow.


Den

[kennethryan]

Some of the earlier Quattro masks leaked around the elbow in the front of the masks and it was hard to tell where they were leaking. [...] It's been quite some time since anyone has had that problem, but I guess it's possible.

Just one data point: I find I still need to tape up the elbow joint. I tape both ends of the elbow, though it may not be necessary to do the hose end. In any case, if I don't tape it I get a noise, almost a whistling sound from the leak. My mask is around 6 months old (cushions newer of course), bought from cpap.com (so I doubt it was old stock). It ought to be well past the time Resmed tweaked it.

*shrug* Neither here nor there, I just thought you might like to know that for whatever reason the problem is not 100% gone ...

ken

[Wulfman]

Some of the earlier Quattro masks leaked around the elbow in the front of the masks and it was hard to tell where they were leaking. [...] It's been quite some time since anyone has had that problem, but I guess it's possible.

Just one data point: I find I still need to tape up the elbow joint. I tape both ends of the elbow, though it may not be necessary to do the hose end. In any case, if I don't tape it I get a noise, almost a whistling sound from the leak. My mask is around 6 months old (cushions newer of course), bought from cpap.com (so I doubt it was old stock). It ought to be well past the time Resmed tweaked it.

*shrug* Neither here nor there, I just thought you might like to know that for whatever reason the problem is not 100% gone ...

ken

Thanks for that info, Ken.


Den