Mirage Quattro Nose Smasher

[jhallas]

Hi Everyone,

I have been using my S9 for about a month now. I started with nasal pillows but I could never keep my mouth shut even with a chin-strap. I am now using the Mirage Quattro which seems to be working pretty well, however I have a couple of questions.

1) Does anyone else feel like you need a higher pressure with the full-face mask compared to the nasal pillows? I moved mine from 11 to 12 and it still feels like lower pressure.

2) Is there a fool proof way to not get those marks on your nose with this mask? If I dial the nose setting out too far it will leak, in too close and it will leave marks. Currently I have it about 6 clicks out from the minimum setting and some nights it will leave marks and some nights it won't.

Thanks,
J

[ozij]

Hi Everyone,

I have been using my S9 for about a month now. I started with nasal pillows but I could never keep my mouth shut even with a chin-strap. I am now using the Mirage Quattro which seems to be working pretty well, however I have a couple of questions.

1) Does anyone else feel like you need a higher pressure with the full-face mask compared to the nasal pillows? I moved mine from 11 to 12 and it still feels like lower pressure.

I do. Pressure from nasal pillows masks feel much stronger. Pressure in a full face maks feels softer, milder.

O.

[SleepingUgly]

Yes, I had a higher AHI with FFM than with pillows, although retrospectively it's possible my AHI with pillows was not valid due to mouth leaks. I can't give you any advice about the Quattro--it pulverized my nose.

[sleepmba]

jhallas,
In response to your first question, at the same pressure setting, a FF will feel like it has less pressure vs. nasal pillows. In the sleep center, when I do titrations, I noticed when switching from one to the other, a FF needs more pressure than nasal pillows to do the same thing. In the cases I've dealt with, it is usually because a FF usually has a higher leak than nasal pillows. The higher the leak, the less effective PAP therapy is. So, when I titrate somebody with a FF, I usually have to increase the pressure in order compensate for the leak. Hope this helps... Good luck!

[bailachel]

Does that mean that if one was titrated with a FFM, gets one and uses it for several minths and then swithches to a nasal pllows, the pressure should be lowered?

[sleepmba]

It's possible they will need less pressure for the optimal effect. There is only one way to tell for sure, a retitration. Unless the person has a data logging PAP machine which would shed some light on the events encountered at what pressures.

[montana user]

I use a Quattro and have just learned to live with the red mark on my nose. I have taken all the FFM from the sleep lab that we use and nothing else really works for me. Wish they could figure out the nose peice a little better.

[WearyOne]

I would think you could just use the data from the LCD screen showing the AHI if you don't have the software--don't know if the basic machines show AHI in the LCD screen or not--to determine if different pressure is needed.

I was tirtrated on Nasal Aire II (nasal prong) and went home with that interface, but quickly switched to the Hybrid (not Liberty). My AHI numbers didn't change between the two. The DME folks made a comment that they didn't know why my sleep doc started new cpap patients on the Nasal Aire because air feels so much stronger with that mask. (I was in there trying to find a FF mask instead of the Nasal Aire!) They didn't say anything about needing a different pressure.

My husband has nose issues with the Quattro as well (his pressure is 19!).

[Daveceepap]

New CPAP patient here, I've got a Quattro mask. I am NOT pleased with that design. Everything works great with the mask EXCEPT the nose deal-- that little red mark turned into that little red scar in no time, even after I bought a Pad-a-cheek nose pad and used moleskin pads inside the mask.

That said, I think I've found a solution, albeit one a bit annoying: I just take a regular ol' band-aid and place it over the bridge of my nose before bed. No red marks when I wake up. (Actually, I'm now using silicone pads instead because I'm trying to get that scar down-- same solution, albeit more expensive).

BTW, I've ordered a Liberty mask just to see how that works in comparison. I'm not sure I'll like it-- my Quattro doesn't leak hardly at all, I wear it tight, and even at 14-18 pressure it doesn't overpower me. It's just that nose deal that ruins the FFM for me, so I'm willing to give a hybrid-style mask a shot.

[jishy]

I tried out the Swift FX's originally... I had trouble trying to breathe properly with it. Either I wasn't getting enough air or it was almost making me gag. My AutoSet average pressure was around 7.5. My reported apneas basically disappeared but I was getting a lot of centrals (CI approx 3).

Now I have been using the Mirage Quattro for a good while. The AutoSet pressure is usually around 9.5. My reported centrals are almost negligent but my AHI is usually about 2.

I also have been using Remzzz liners, my 1st two nights I had very little leak and an AHI of 0.1 and 0.2. Now it's back to AHI 2-3 and I don't know what has changed Waking up tired.

[KC5cychris]

I have \been using the Quatro for two weeks now with no issues
My DME set it up with the bridge pad pulled out a bit and sitting in about the same position a ballcap would sit on your forehead then put the lower straps on. I made a couple adjustments for leaks on the lower straps but have not touched the upper position if you run the knob out it will take the pressure off the nose a bit but the seal will still work at most pressure settings

Chris

[Mtnviewer]

I've been happily using this tape, read bottom of page, wiki/index.php/Pain_on_the_Bridge_of_the_Nose for many months & have zero marks or sores or pain using the Quattro & tape. I highly recommend it.

I'd also suggest that you video tape your sleeping to see when your pressures are the highest and IF it is in a supine position (on your back), then I'd also suggest that you try as many things as you can to keep yourself in a side sleeping position. A side sleeping position (of your body AND your head, as they wil move independantly, so even if your body is on it's side, your head may turn onto it's back and so OSA will result) could also allow you to lower your pressure, maybe A LOT, and so your mask tension would also be lessened and so would the pressure on your nose. Learning or using aids to force oneself into a side sleeping positon for the head AND the back, may be the best form of therapy for OSA along with a PAP machine, but most are unaware of when their OSA occurs, and so just leave it up to the equipment to try and deal with apneas. A video study of your sleep could tell you many things and help you solve the problems vs. just guessing, or having others guess.

One other thing, with higher pressures and higher mask tensions, your mask headgear may stretch over time and require fiddling with tensions top and bottom, as well the velcro closure on the Quattro headgear also loses it's grip over time. My headgear tabs are now head in place with staples as the velcro will no longer hold.

Fiddling with PAP therapy is never ending, but worth it. Try the tape at the very least.

[sleepmba]

Tying up a loose end here... If you can get the same seal with a FF as you did a nasal or nasal pillow mask (same leak rate), then you shouldn't need a change in pressure.

[kevincoop]

I have been working with the quattro for a while and it is a great mask, but for alot of people it makes marks. I have recently came across Sequal's Sleep Comfort Care Pad

•Decreases skin breakdown and facial sores
•Acts as a barrier between mask and skin
•Improves mask comfort- nasal & full face
•Reimbursable under HCPS code A7032
•Wash with warm water before each use.
•Recommended replacement is approximately every 30 days.

I have only given out a few but they have worked well so far. Anyone else tried this?

[Rustyolddude]

My tip for Quattro fit. Lying down with your head on your pillow, mask strapped on, air off. Pick it up off your face & let the bottom of the seal touch your bottom lip, then position it just a little lower so the seal is in the divot between your lip & chin, and release. Make "fishy lips" to get the seal to position at the corners of your mouth. Crinkle your nose i.e. make a "stinky face" to get the seal positioned on the bridge then lift the head brace with your forehead in a relaxed position and release. Connect the hose & air on, adjust the knob for no leaks in your eyes. Top straps should only be as tight as required to keep the forehead part from sliding left & right when you roll your head. It's taken me a year but I've pretty much got the Quattro bugs worked out and no more nose sore.