I THINK I've made my peace with the Quattro

The Quattro was the first mask I was given and after just a few nights of horrible leaks (especially eye leaks), sore and red nose, total frustration, I moved on to other masks, eventually--after many tries--settling on the Swift LT and FX masks. I never looked back and thought there was no way I was going to ever use the Quattro again, although I kept it around "just in case" I got a cold. I decided it was a lousy mask, even though others rave about it.

CPAP has had many positive benefits for me and one of them is in the first 10 months I used it I had NO upper respiratory infections (colds) whatsoever--something of a record for my entire life. Usually I get between 4 and 10 colds a year (10 in the years my kids started in new school environments and brought home lots of germs to share). I have asthma and heart problems, so colds are never a minor issue for me, although many are mild.

About 2 weeks ago I had my first ever URI on CPAP. It was a really mild cold, and I kept using my Swift FX right through it until it hit me on the backside with a lot of nasal congestion and coughing. I actually slept without CPAP most of one night, but drove my husband out of bed with my snoring and I felt like truly terrible the next day. At that point it was clear I had developed a full-blown case of asthmatic bronchitis.

I’d tried the Quattro for a little that night and just could not get comfortable, but I could not get enough air through my nose for anything less than a FF mask.

The next night I was determined to sleep with the Quattro after I made it only a few hours with the Swift FX. I rethought everything I’ve heard about how to fit it properly, and this is what I did.

1. Loosen all the straps, and dial the forehead piece out as far as it will go, tilting the nose piece as far away from your face as possible. Lay down flat on your back with your head on your pillow.

2. Put the Quattro on over your head and arrange the back straps for easy attachment.

3. (I got this from watching the video for the new Quattro FX) I tilted the mask out away from my chin and THEN turned on the machine to allow the cushion to fully inflate.

4. I brought the lower part of the mask down on my face and attached the clips. I used one hand to gently hold the bottom part of the mask against my face. The goal was to stop the leaking while putting as little pressure as possible on the cushion so that it could fully inflate.

5. I tightened the upper straps as little as possible, just enough to stabilize the mask. I wanted to keep that area very loose to avoid pressure on my nose.

6. Now I tightened the lower straps. These, by necessity, have to be tighter than the upper straps, but again I wanted that cushion as inflated as possible. One trick is to only tighten them during the inhalation phase of the machine cycle, so that the cushion is very full when you are setting it. (I turned AFlex down to 1 for wearing the Quattro as it reduces that “pounding” from the release of expiratory pressure. My normal setting is 3).

The top was very loose—in fact I could easily put a finger between the forehead pad and my head. But the air pressure in the cushion was sealing the top of my nose nicely (it reminds me of how the Activa will seal agains the nose). The bottom was somewhat tight, but not uncomfortably so. To my amazement, I could turn on my side and there was enough play in the top that doing so did not push the hard plastic against my nose. I always sleep on my side. I didn’t even have to adjust the bed pillow very much to be comfortable—the loose fit of the mask could accommodate the pressure against the pillow.

I slept 8.5 hours and woke up feeling so comfortable. I coughed a moderate amount during the night, and it was no problem with the FF mask. There was not the slightest bit of pressure on my nose, and no eye leaks. I could scarcely believe it.

The next night was not so easy. I had to readjust the mask again and didn’t quite reach the same level of comfort I’d had the night before. But last night I carefully followed the steps above, and had another very good night with more than 8 hours of good restorative sleep. This is especially noteworthy because I’m on Prednisone right now, and it can really mess with my sleep. I woke about 6 a.m. with a pressure leak because my pressure had hit 15, so I readjusted for the face fart and hit the ramp button (very unusual for me to need this) to bring the pressure down to 9, and slept another two hours.

I never thought I could sleep comfortably in this mask. I thought at best I’d end up in the recliner chair wearing it for a few hours so I could get a little sleep. I never get much rest when I have bronchitis this bad, but the CPAP is allowing me to sleep quite comfortably, now that I have the Quattro mastered.

this sounds good to me. There is a function on the s9 that lets you test the mask fit and it runs at whatever your full pressure is for 3 min. That would probably be the best setting to use to fit the mask. at the moment I am reasonably happy with the fit of my mirage quattro but I have printed your instructions for when I feel inclined to fool around with it. thanks

Isn't this mask similar to Quattro?

http://www.cpapsupplyusa.com/Fisher-Pay ... 432AX.aspx

I have been using a FX since the beginning but I also have a Quattro and it sits in a box behind my recliner. For a long time I never used it more than 20 minutes at time while watch tv. One night I put it on while in my recliner and I got it adjusted with no leaks. It worked great for 30 minutes so I turned of my machine that sits next to my recliner. I left the mask on and headed to bed and hooked it up to my s9. After trying for 20 minutes to make it work I jerked it off and put on my FX and went to sleep. I have never tried it again. I know I need to learn how to use it in case I get a bad head cold. I'll keep your technique in mind.

Isn't this mask similar to Quattro?

http://www.cpapsupplyusa.com/Fisher-Pay ... 432AX.aspx

They look similar. The ability to dial the forehead piece in and out on the Quattro is the key difference, and for the fitting technique I described above, it's crucial to keep the forehead piece tilted away from the forehead as much as possible to prevent any pressure to the nose.

I tried an F&P nasal mask (the 402, I think) and it sealed really well, but tore my nose to pieces.