CPAPtalk.com

It's simple: get another mask. The Quattro is a poor design to say the least in my opinion.

desert rider wrote:So I'm looking at the data now, but I'm not sure what my vent rate is supposed to be for the mask. According to the literature, it looks like it's supposed to be around 41 for my 12 cm setting (not sure if I'm looking at the right info in the manual). My leak graph is very flat (for me) at just over 50 most of the night. I don't know if that's optimal or not (since I don't have any baseline success to compare it to).

DR, yes you are looking at the right info in your manual. At your pressure, your leak line should be at no more than a couple of points above 41 to be "managing the leaking" effectively. IMHO 50 is not at all optimal, even if your leak like is flat. It is great that you figured out to adjust the mask to your most common sleeping position. But before you give up on this mask--rather than cranking down the mask so tightly (which can actually be counter-productive), have you yet tried using the silicone earplug trick to fill in the places that are leaking?

I personally think that of all the many FFM's I've tried, the ResMeds have the best design---for me. The Ultra Mirage and Quattro have similar featues of the adjustable bridge, which I prefer (have never gotten sore there)--and each one is shaped for a different facial shape/configuration I think, so we usually see that when someone fails with one, the other works better. YMMV.

plr66 wrote:have you yet tried using the silicone earplug trick to fill in the places that are leaking?

plr66,
I also have a Quattro with persistent leaks by my eyes. Could you please explain in detail the "silicone earplug trick"? I don't quite understand what I am supposed to do with the earplug.
Thanks,
Cobalt Panther

Cobalt Panther wrote:

plr66 wrote:have you yet tried using the silicone earplug trick to fill in the places that are leaking?

plr66,
I also have a Quattro with persistent leaks by my eyes. Could you please explain in detail the "silicone earplug trick"? I don't quite understand what I am supposed to do with the earplug.
Thanks,
Cobalt Panther

Aarghh--I'm a terrible searcher, but if you type in "Mack's silicone ear plugs" in the Search box at the upper left, you'll get way more links than you want. Here's one I picked without much looking, that seems to have some good discussion:
viewtopic.php?f=1&t=26407&p=313240&hili ... gs#p313240
I hope others will chime in with the more basic thread about this "fix."

plr66,
Thanks for the link!!! It has given me some ideas to try. I need to get the leaks under control so that I can get some sleep. Thanks again!
Cobalt Panther

I have, perhaps, one tip to suggest. I have been using a Quattro for about three months since I gave up on my first trial appliance, an Opus nasal pillow device that didn't work for me without a chin strap, and was then intermittently unreliable. Since switching to the Quattro I have had very good results, needing only one modification of procedure to achieve excellent performance. After only a couple of nights of experimentation I achieved what I thought was a satisfactory fit. One adjustment was over against a stop. The forehead pads were as far forward as they could get, corresponding to "tightening" the adjustment knob to its last stop.

The initial optimum setup was not perfect, however. My problem was an occasional leak at the top of the mask, pointing a small jet of air to the corner of my eye. This could happen on one or both sides of my nose, and usually opened up when I rolled from my back to one side or the other. I noted that, while lying on my side, I could stop this leak by thrusting my chin slightly forward (i.e. tilting my head backward). Since I knew I could not maintain that distorted posture while asleep, I sought an alternative remedy. Without changing other adjustments I reset the forehead pad nob to a position six or seven clicks more open than its original position. I then don the mask by placing the forehead pads first, the bridge of the nose second, and finally I place my lower lip inside the pad while pulling down slightly on the mask. I then connect the hose and start my machine by breathing. I find the Quattro fairly comfortable, and the seals work in this new position when I am on my back, and sometimes even when I roll onto my side. The aforementioned leak often opens up, however, and I find I can always close it reliably by turning the knob tighter, effectively tilting the mask in the same direction relative to my head that thrusting my chin forward would achieve. Even three or four clicks will sometimes do the job, but I usually tighten it all the way now.

I mentioned the comfort of this mask. I find that I can yawn, cough, or even sneeze without having to remove and replace the mask. I am using a small size pad even though it seems to me that I am squeezing a bit to get into it, my lower lip pressing against the bottom of the mask. However I must distort my face quite a bit to make a leak in the lower part of the mask, even if I skip shaving for two or three days. I have no significant leaks even if I roll onto my stomach during the night, except for the time I somehow caught my hose and disconnected at the upper joint of the Quattro (not the one where you are supposed to disconnect). Reassembly was achieved without great difficulty without turning on a light.

I have a new Respironics machine now and I am getting lower AHIs than I was getting with my older trial machine. After 34 nights I am getting AHI averages of 1.5-1.7 per hour.

Cobalt Panther wrote:

plr66 wrote:have you yet tried using the silicone earplug trick to fill in the places that are leaking?

plr66,
I also have a Quattro with persistent leaks by my eyes. Could you please explain in detail the "silicone earplug trick"? I don't quite understand what I am supposed to do with the earplug.
Thanks,
Cobalt Panther

Cobalt if you are having air leak into your eyes I have found it is one of two things. 1 your dial is set wrong and the mask if too far away from your face or 2 the mask is too high on your face and not sealing properly.

Gerry

Gerryk wrote:Cobalt if you are having air leak into your eyes I have found it is one of two things. 1 your dial is set wrong and the mask if too far away from your face or 2 the mask is too high on your face and not sealing properly.

Gerry,
Thanks for the tip. My mask dial is set closest to my face. I tried dialing it in and that never worked. I always ended up with the mask right on my face. Your second point has me wondering. How do I know where the mask should fit on my face? How do I know that it is too high? Do you have some point on your face that you line the top of the mask up to? Also, I am not currently using the Quattro headgear. I am using the PapCap Plus with the chinstap. The chinstrap is not tight. I use it as a gentle reminder to keep my mouth shut. My leak line is much better since I started using it! Any tips/tricks for aligning the mask would be greatly appreciated Maybe I should try reading the instructions again (if I can find them).
Thanks again for your help
Cobalt Panther

CP, here's a video from the cpap.com website, which I think has a section on fitting the mask. It's for the UltraMirage, which is very similar to the Quattro--both made by ResMed.

https://www.cpap.com/downloadVideo.php?VGID=26

I too have found that moving the mask just a tiny bit up or down my nose/face can fix leaks. Don't drag the mask up or down when snugged up, however. You should lift the mask off your face to replace it, otherwise the cushion will be contorted and not seated properly.

plr66 wrote:CP, here's a video from the cpap.com website, which I think has a section on fitting the mask. It's for the UltraMirage, which is very similar to the Quattro--both made by ResMed.

https://www.cpap.com/downloadVideo.php?VGID=26

I too have found that moving the mask just a tiny bit up or down my nose/face can fix leaks. Don't drag the mask up or down when snugged up, however. You should lift the mask off your face to replace it, otherwise the cushion will be contorted and not seated properly.

plr66,
Thanks for the link. Unfortunately, the download did not work for me. Probably had something to do with the dang dialup internet I have. I will try out your other tips tonight and hope for a good outcome.
cobalt panther

Cobalt I just kind of figured it out by trying different positions. See what is comfortable then see where as far as high or low has the least leaks. Then I combined the two of where it was leaking the least then comfort and adjusted from there.
I thought the Quattro was designed to kind of hold your mouth shut some. Anyone know if that is correct?

Gerry

[quote="Gerryk"] I thought the Quattro was designed to kind of hold your mouth shut some. Anyone know if that is correct?

The Quattro (and most FF masks) are designed for people that breath or leak air through their mouth. They are not designed to keep your mouth shut. You need a chinstrap for that.

LSAT wrote:

Gerryk wrote: I thought the Quattro was designed to kind of hold your mouth shut some. Anyone know if that is correct?

The Quattro (and most FF masks) are designed for people that breath or leak air through their mouth. They are not designed to keep your mouth shut. You need a chinstrap for that.

I wore a Swift II and FX for 18 months but kept having mouth leaks once I got into deep sleep. I tried the Ruby Chinstrap and the PapCap and even taping but it was just more uncomfortable than it was worth. I really couldn't train myself.

I switched to a Quattro 6 weeks ago and the first few nights my mouth was dry because it was open. It's pretty rare now for me to wake up with dry mouth which indicates I must have trained myself to keep it closed.

I might switch back someday to see if it keeps.

I do have leaks like most with the Quattro when I lay straight on my back. I need to fiddle some more with that but I can lay on my side quite comfortably which I could never do to the same level with the Swift. I also really enjoy not having to tape or use the chinstrap. I was getting TMJ from that.
With tape I would wake with the tape drooling wet.

no_more_headaches wrote:I do have leaks like most with the Quattro when I lay straight on my back.

Funny - That's the only position that doesn't leak (much) for me.

The Quattro has given me the best seal so far, but as I've written here before, I can not get a good seal to hold when lying on my back. My data shows a near-perfect leak line most nights. It's the tiny little leaks that can drive me nuts, however. When lying on my side, I don't have leaks unless I bump the mask somehow.

When lying on my back, the seal will hold until I just drift into sleep. Then the tiny leaks begin right in the middle of my cheek. The funny thing is that while awake and lying on my back, I can tug and pull on my face, chin, cheeks, etc. and can not make it leak. But as soon as I doze off...

Tony