Mirage Quattro FFM

[SleepyBobR]

I just purchased a Mirage Quattro FFM after using the Swift mask since starting CPAP 2 months ago. I've used the Quattro for 5 nights now and like it much better than the Swift as it has allowed me to dispense with the chin strap I had to use with the Swift. I was worried that I would have a lot of trouble adjusting to the full mask but that hasn't really been the case. I haven't had much issue with leakage and I'm not tearing the thing off my face in my sleep like some others have reported. My titrated pressure from my sleep study last week was 7 but I know it's wrong because I hardly slept in the study and I tried one night at that setting and my headaches and chest pains were back in the morning, just like before starting CPAP. So, I'm gradually running the pressure back up. Last night I set the pressure to 9 and, when I checked at 1AM, my AHI was 3 (AI was 0!). In the morning, it was up to 6.8 with AI at 1.6. This is my pattern. Things always deteriorate between 2AM and 7AM for some reason. Leakage was only at .08 for the night so was not an issue. So, tonight I plan to run at 9.2.

My question relates to managing leakage with this mask at higher pressures. I've noticed as I've increased the pressure that I've had to really start cinching up the straps and this is starting to get uncomfortable. Should I really have to tighten the straps so much to maintain a proper seal that the mask starts to hurt my face? Or am I missing something here and there's a way to get a good seal with looser straps? So far, so good on the bridge of my nose. No problems there but I do notice some pretty significant bags under my eyes with perhaps a hint of bruising? Not really sure. How on earth does anyone tolerate this mask at the higher pressures some are running at if I can't use it comfortably at a pressure of only 9?

Thanks for any tips.

[Arizona-Willie]

I'm using the Quattro with a pressure of 11 with no problem.

It may take quite a bit of fiddling to get the straps adjusted right but it should be doable.

I know people use the Quattro with pressures far higher than mine.

The mask should be loose enough that if you reach up and push on it you can feel it compress further toward your face.
The idea is for it to be sitting on a cushion of air, so you don't want the straps so tight that the mask is smooshed hard against your face.

[no_more_headaches]

I have been told you reach your deepest sleep between 2am and 7am. As a result your relaxation and your apnea needs are probably worse then. So your results do not surprise me.

I started with the swift as well and the eventually the chinstrap and even taping. It was all just a bit too much. I went that way for 15 months.
Last August I switched to the Quattro and it was much more convenient. That said I noticed little differences like with the swift I would wind up sleeping flat on my back for the lowest leeks.
With the Quattro I now sleep more on side as I get more leeks flat on my back.

I also notice I need a little higher pressure with the Quattro. Now if I try to use the swift I feel more uncomfortable pressure in my lungs.

I would be interested to hear if others had to tweak their therapy when switching between pillow, nasal, and FFM type masks and how much of a difference it was.

[LSAT]

I am using the Quattro at 11psi with few problems. I can fall asleep without any noticable leaks but wake up at 4-5AM with some small leaks...problibly from moving my head back and forth during the night. I found that it is important to wash your face before putting on the mask and, I use the citrus wipes to clean face oil off the cushion daily.

[SleepyBobR]

LSAT, big time agreement on the importance of washing the mask and your face before putting it on. I am doing that religiously.

[Gerryk]

Your are probably having the most problems during a certain time because that's when your reaching your most relaxed state while sleeping, causing your OSA to be at it's worst. As far as washing your mask and face, it's always a good idea to wash your mask and face. However don't use something that will dry your skin in hopes of getting all that oil off your skin and the mask sealing better. Your body will know that the oil was removed from your skin and replace it because it knows it needs that there. This will just cause your body to create a more oily face than normal and things will actually get worst. Just soap and water nothing else to remove the oil.

Gerry

[yorkiemum01]

LSAT said it....a clean mask stays sealed well, and also on a pressure of 11, rarely a leak. My
personal experience is cinching down snugly, but sure each persons facial structure could play a role.
LOVE my Quattro though (compared to other FFM's I've tried)

[plr66]

LSAT, big time agreement on the importance of washing the mask and your face before putting it on. I am doing that religiously.

And for those of us who have had the opposite experience...

viewtopic.php?f=1&t=49416&st=0&sk=t&sd=a

By not washing my mask, I have been able to loosen my straps so that the cushion inflates and none of the hard frame sits on my face. So much more comfortable, and leaking is minimal.

Try it for a number of nights each way, adjusting your straps as needed, to get the least pressure on your face possible. I find that at least once a night I loosen or tighten the nose bridge. No big deal, and it becomes automatic.

I have never received nor seen any clear explanation on this forum regarding the bags under our eyes with cpap. It just seems to relate to the air pressure going into all our facial cavities. I use a small blue ice pack applied under my eyes on my drive to work, and it seems to reduce them significantly.

[SleepyBobR]

Well, that's certainly interesting. I'll have to take that in account and give it a try.

[newhosehead]

I use the Quattro at a pressure of 14 and the leaks are not any worse than they were at my beginning pressure of 10. Some nights they are awful, other nights no problem. I cannot figure out what the variables are. I dont mind this mask at all except for the oft-reported nose bridge issue...just ordered the comfort care pad, some report great results, others say it did nothing. I am going to give that a try and if that doesnt work, I have got to have a different mask.

[CPAPcub]

SleepyBobR

I am a relative newbie to this site and have only been using the Mirage Quattro FFM a few weeks but I will pass on my experience of it so far in case it can be of sme help.

Firstly - keeping face and mask rim oil free is really important and drastically affects the quality of the seal I have been able to achieve. I am running at 17 pressure and have been able to obtain virtually no leaks by cleaning my face just before bed and then wiping the rim of the mask every night to remove face oil, grease etc.

I use Clearasil face wash which comes in a plastic tube. Put a little in your palm, scrub your face and rinse / dry well. Only takes a minute or so but makes all the difference.

** A comfort tip ** One thing I noticed with this mask when I first used it was how painful the forehead part of the mask assembly was on my skin - often waking up with red sores. Yet I had to have the upper bridge fairly tight, so what to do?? Well, I turned to a trusty elastic hairband - some people call them an 'alice band'. Fold the band over in two and place around your head. Next, with the top two straps slackened off, place the two plastic cups on the upper part of the mask over the band. Tighten one upper strap at a time. Then, tighten the lower straps one at a time. Recheck the upper straps. What I have found works well is to tighten them just to the point where discomfort starts and then slacken off a tiny bit.

So having to readust the straps every night takles a couple of minutes but what price a healthy night's sleep?!

I'm still experimenting with my pressure settings. I'm down to 6 or 7 AHI but want to get it under 5.

Hope that helps.

[Patzee]

SleepyBobR am using my Quattro full time now, with my S8 II in (cpap mode for daily use), @ pressure 13.4 with zero leaks (and was up to a pressure of 14 at one point with no leaks as well.)

However, the ZERO leaks came after I added the trick learned from our fab forum here think it was Rested Gal... the cut off leg from a pair of pantyhose-tights... tied across the face of the Quattro & around my head angled up wards somewhat. Its stretchy leg wraps below the hose articulation by the way.

I kind of flatten and spread out the leg so it covers more surface area of the mask (rather than using it as a narrower band), and making sure it grabs on and covers the two blue clips - conveniently acts as a anchor - and I even stretch the leg further, to include the bottom-most portion of the mask where it hits my chin.

Then I tie it behind my head using Rested Gal's knot (not tying a knot per se, but wrapping one end of the leg under the other end of the leg three or four times while tugging gently to snug it) that effectively locks it tight without what would otherwise be an uncomfortable hard knot.

Where I am a "flipper" (all night long!), my previous leakage issues had to be solved; thankfully, this method solved my situation.

Know you'll find what works best to solve your issues as well!! Patzee

Meant to add:

that I've got the baggies-under-the-eyes too, which wasn't the case before using the Quattro fulltime..guess it goes with the territory.

and, I don't over tighten my headgear straps before adding the pantyhose leg....just adjust them to comfortable.

[pb5927317]

My pressure is 20 and actually needs to be 24 give that a try!

I use the Remzzzz's with the Lanonlin cream!

[Mary Z]

I used to love my Quattro, it's still my favorite mask. At a pressure of 18/22 I had to cinch that thing down pretty tight to keep leaks under control, but it could be done. Just no comfortable "cushion of air" for the mask to float on. The bridge of my nose unfortunately reached it's total breakdown point after 18 months of using the Quattro. I have thin skin, prone to breaking out and have scars from the pressure sores. Recently had to take a fortnight off CPAP totally to let my nose heal. I'm trying the Respironics FitLife Total Face Mask now and having leaks with that mask.
By far my favorite has been the quattro and I've tried every remedy out there except the "alice headband" for the bridge of my nose. Could you elaborate a bit more on this headband? I just can't seem to get a picture in my mind.
Thanks all,
Mary Z.

[CPAPcub]

I used to love my Quattro, it's still my favorite mask. At a pressure of 18/22 I had to cinch that thing down pretty tight to keep leaks under control, but it could be done. Just no comfortable "cushion of air" for the mask to float on. The bridge of my nose unfortunately reached it's total breakdown point after 18 months of using the Quattro. I have thin skin, prone to breaking out and have scars from the pressure sores. Recently had to take a fortnight off CPAP totally to let my nose heal. I'm trying the Respironics FitLife Total Face Mask now and having leaks with that mask.
By far my favorite has been the quattro and I've tried every remedy out there except the "alice headband" for the bridge of my nose. Could you elaborate a bit more on this headband? I just can't seem to get a picture in my mind.
Thanks all,
Mary Z.

Hi Mary,

My use of the 'alice band' that I mentioned in an earlier post on this thread is on the forehead, not the nose. Fold the band in half, place over your forehead, then place the two plastic oblong cups at the top of the mask assembly over the band, then tighten down the straps. Doing this stopped pressure sores that had developed on my forehead from the plastic cups on my skin.

Hope that helps