Masks...which one?

[flowergal3]

Since I started on CPAP, I have tried out six masks so far: Quattro Mirage FF, Fisher-Paykel Forma (with small & med. inserts) Swift LT for Her, Mirage Activa LT Nasal, Mirage Micro Nasal, and finally, the new Quattro FX.

I was sent home with the original Quattro first, and then tried out the next five in a row. I couldn't get comfortable at all in either of the nasal masks, too much pressure under the nose, etc. The Swift LT has possibilities, if I could get used to the nasal pillows. Couldn't get the FP Forma to stop leaking no matter what I do, and ditto for the Quattro FX which is also hard on the nose.

I've tried all of the above masks for several nights, and always end up going back to the first FF Quattro I was given originally; not because it's all that comfortable, but because it's a little more comfortable than the other five choices. I do have leakage with this one, too, around 20L an hour, don't know if that's acceptable or not.

My 30 day trial period of mask exchanges is almost up (though my DME said he'd be a little flexible) and I don't know if I should keep searching or just settle for the Quattro and call it good enough. My DME has been patient, so far, but I can tell it's getting to the point of "I don't know what else to do for you lady."

So, my question is this:

Did anyone find THE perfect mask for them and how many did you have to go through before you did? Or did you just pick a mask that you could tolerate most of the time?

[Wulfman...]

So, my question is this:

Did anyone find THE perfect mask for them and how many did you have to go through before you did? Or did you just pick a mask that you could tolerate most of the time?

Yep! The very first one. The ResMed Ultra Mirage Full Face.
After doing a fair amount of preliminary research, it's the one I selected to begin my therapy nearly six years ago. I've picked up a couple of others along the way, but never could tolerate them for more than a few nights......and always came back to my UMFF.
By the way, I'm still using my first mask even though I have several spare (identical) masks and spare cushions. It just gets better with age/use. My first headgear lasted nearly four years.

Good luck.

Den

[flowergal3]

Thanks, Den. I will have to check and see if the Ultra Mirage FF is available to me. Isn't it an older version of the Mirage Quattro? I wonder what was changed? I have to find something and fast, time is running out!

[jbn3boys]

There are so many masks, and so many different faces, that what works for one person may be terrible for the next person. There is really no rhyme or reason as to what seems to work for whom. Unfortunately! With that being said, I know there are people on the forums who have tried more than a dozen masks to find "the" one. I'm on my fourth, and while I like it, and it's comfortable, I'm still having some issues with leaks, so I may have to look farther. I'm currently using the Swift FX for Her, and really like it. However, I could not even think of using it in the first month or two of treatment--it was just too much air forced into my nose. Once I got used to the air pressure in a nasal mask, then I was able to move to nasal pillows. Maybe the Swift LT will just take a little more time to get used to. Don't be afraid to keep trying until you find a mask you are comfortable with. If your DME runs out of ideas, then I would suggest going to cpap.com and buying one for yourself. I know they aren't cheap, but it is so worth it to find one that works for you--it will make it so much easier to stick to cpap treatment for the long haul. Also, there is a mask trial program through sleepnation.tv, where you can simply pay for postage to get masks delivered to you, try them, and then pay return postage to ship them back. I haven't used this program, but I know others here have. You can also search the forums for tips on how to make the Quatro more comfortable. I'm sure there are tips and tricks out there. Just don't give up!

[LSAT]

My perfect mask is the Quattro...from day one. The key is to get the right size (they tend to run a little big) and to put it on properly.
Also flowergirl...the Quattro and the Ultra Mirage are both available as is the new Quattro FX.

[HoseCrusher]

My Respiratory Therapist sized me up and said that I looked like a "medium Swift FX."

After a detailed fitting under pressure, I was advised that when (not if) my mask fell off my face, I would need to tighten 1 notch only and go from there. I told him that it felt loose enough that it would fall off of my face. He smiled and had me move my head around. Surprise, it stayed in place.

There was a night or two of adjustment, but it has worked great for me.

I give all the credit to my RT for sizing me up correctly.

[Wulfman...]

Yes, it's about six years old, but in my opinion, it's a better mask.
I think what ResMed was looking for in the Quattro was a mask that had fewer parts and was cheaper to manufacture (more profit). In the process, they changed some things that made sense on one hand, but ended up with something that wasn't as well designed as it could have been.
My first impression of the Quattro (yes, I have one) was that the seal was very comfortable and had a better-designed cushion clip. The exhaust vent was very quiet, but didn't seem to exhaust enough CO2 and consequently left me feeling less-then-refreshed the following day. The forehead adjustment was a change, but not that much of an improvement, although it might be a little more durable in the long run. The biggest problem that people had with the first generations of the Quattros (and may still) is the design of the front elbow and anti-asphyxiation valve.......they leaked like crazy in no time (it's hard to imagine that they tested them for any length of time). Most of us ended up pulling the elbow out of the mask and wrapping the ends with several wraps of (plumbers) Teflon tape. That solved that problem.
Size-wise, the Quattro tends to be just a teeny bit larger (longer) than the same size UMFF. I wear a Large UMFF but the Large Quattro is on the verge of being too large......but it still works OK. So, determining the proper size on ANY of these (or other) masks is very important.

The other thing that's important is the tension and strap adjustments. I like to wear either of them with the top straps VERY loose and any tension is on the bottom straps. That allows the upper part of the cushion to get a better seal on that area of the bridge of the nose. I also adjust the forehead support in the forward-most position (away from my forehead)......mine doesn't even touch my forehead. In other words, it pretty much floats on my face and I've never had any of them cause any pressure sores on face.


Den

[KimberlyM]

Another Swift LT user here. It is the perfect mask for me because it doesn't fit tightly on my face and head. Also, fitting the right size nasal pillows is crucial. You don't want them shoved completely up your nose and when you begin the pressure pull them away and reseat them so they are just barely in the entrance of the nose. The mask is loose and I can toss and turn in it with no problem. Check out Janknitz fitting guide for the Swift, it may help you to adjust your mask for the best fitting. Her instructions are for the FX, but the principal remains the same.

http://maskarrayed.wordpress.com/swift- ... ing-guide/

Nasal pillows do take a little getting used to.

[Beachmeezer]

The mask I used in my sleep study was the one for me a nasal mask - Zest Petite. I used that one for a year and wanted to try nasal pillows. I've been trying a Swift FX for her and am loving it. I couldn't tolerate the nasal pillows a year ago but can now.
Kim

[Janknitz]

It took about 8 masks until I found a great one, and then one more that was absolutely perfect for me. This is where "try, try again" becomes really important.

The other thing I might suggest now that you have some experience under your belt is not to be afraid to revist a mask you previously rejected (if you got to keep them) because you may have a better understanding of fitting them now and may find that they work just fine. I've had that experience with the Quattro and Mirage Micro--I couldn't wear them when I first tried, but when forced to return to them after I couldn't use nasal pillows for a while I sat down and "deconstructed" the fitting process to see if I could work aroun the problems I was having and I DID. So now instead of only 2 great masks, I have 4 masks I can rotate as the situation and my whim dictate.

The mask is KEY. If you can't get comfortable, you won't be compliant, and that DME will lose a repeat customer because you don't need a steady stream of new supplies for a CPAP that's sitting in a closet. So it's to HIS advantage to keep working with you on masks until you find the right one (and it's 30 days for EACH mask for the manufacturer). So keep looking and don't worry about the DME--he can take care of himself.

[bap40]

Swift LT for her is my mask of choice. I tried an opus 360 right after I started therapy and it hurt my nose terribly. So never tried any other of the nasal pillow types. A year later I did with the Swift LT for her and loved it. I do have to modify it a bit towards the end of my 6months by glueing velcro so I can tighten the straps that are stretched out. I tried the Swift FX and could not get that one to even stay on my head so went right back to the LT. As a nasal mask I have 2 I like. The comfort gel which was my very first mask and the Activa Lt. Both work! I did go thru many masks at first to find the perfect one and came away with not perfect but pretty good. I bought mine thru cpap auction as I could not afford to do it any other way. I just waited for what I wanted to try out next to come up for sale and did it that way.

Good luck and don't be afraid to modify your masks. A lot of us do just that.

[digitaleagle]

I started out with a F&P Zest - couldn't get used to it, then switched to the Swift FX pillows. I used those for about 2 months. I then experimented with the Resmed Softgel, (as I had tried this before my titration) and am now leaning towards this mask. I have fewer leaks, better AHI's, and I'm sleeping better. I thought the FX was the best for me - but I still haven't gotten used to having pillows up my nose and I have more nightly leaks with them. If you haven't tried the Softgel - it might be worth a try.

[msradar65]

My perfect mask is Swift LT for her. I do go back and forth on the pillow size between XS and Small.

My back up mask is a fullife full face mask which I love too.

[flowergal3]

jbn3boys, It's really good to hear from someone who had some trouble adjusting to the nasal pillows. At least I'm not alone, and maybe there's hope for me with them yet, a little farther down the road with this experience. I'm still a CPAP rookie, so I have a lot to learn and get used to. Thank you for the encouragement, I won't give up!

LSAT, I will have to look into fitting procedures for the Quattro and also see if maybe I can try a Ultra Mirage.

Hosecrusher, I think I need to try the Swift LT a little bit more, it is kind of hard to get used to it being so loose on my head, but I bet that's the beauty of it.

Den, I think the fitting of the Quattro Mirage is where my problem is coming from; the DME had it cranked down as tight as it would go when we met with him for the first visit with the dial turned in as close to the head as possible. I'm going to try the fitting tips and see if I can make this mask work. Thank you for your detailed reply!

KimberlyM, I will check out the fitting guide. I have to figure out which pillows would work better for me, what bugs me the most is the 'whistling' on exhale I kept experiencing. Probably because I had something wrong with the adjustment.

Beachmeezer, thank you for your input, maybe I just need to give myself more time with the nasal pillows.

Janknitz, great advice, I will revisit several of these masks again now that the newness of CPAP usage has worn off a bit. Though they call it a mask 'exchange' so far the DME has not taken any of the masks I've tried away from me so it gives me a chance to 'try, try again!'

bap40, I like your idea of modifying the masks, too. I did sew some velcro into the headgear of the Swift LT so it wasn't so slippery on my head and it worked very well.

digiteagle, the Resmed Softgel sounds like a good one to try. It's great that I have some brand names to toss around with the DME.

msradar65, I'm glad to hear the Swift LT worked for you, and I hope it will for me, one day, too. I have to give it another try, and maybe alternate pillows.

I think I will try mask liners too...maybe that will help (or worsen) leakage rates. I guess the only way I'll know is to experiment. On the night of my sleep study, they brought in four different masks, and one had an almost accordion-like silicone seal in it which was also quite comfortable. I don't now the name of that mask, but maybe I can call and find out from the sleep lab?

Thank you all for your great responses, you're so helpful!

[rosiefrosie]

The mask they used at my titration, the Swift 11 was the perfect mask for me from the start, Oh, I tried a few other out of curiosity, but always came back to the first. I now use the Swift LT for her and this works just as well. Hopefully this mask will be on the market for as long as I need it!

rosie