Quattro Mask Seal Issues

Might the sleep center let you try a size down (or up) to see if that might help?

Also are you cleaning the mask seal daily? (I know most of us do, but my DME told me weekly would be fine so I check.)

When you adjust your mask before going to sleep do your final adjustments laying down and at full pressure. Also make sure to test out the seal in several positions. I get the leaks you're describing when I am on my back so I make sure to eliminate them there first. Once you get a good fit, do your best not to fiddle with it...I've lost so many perfect fits that way.

How about the hose management?
Sometime, it's our movements that affect the hose, and the hose dislodges the mask.

Here's a recent thread in which people describe how they manage full face masks:

viewtopic/t47806/Hose-managementcurious.html

Some people have used Mac's silicon ear plugs, rolled into snakes and put on the seal -- either all around, or where it leaks.

O.

When you used the quattro did you wake up with marks on your face or forhead that took a while to go away? If so you had it too tight. A quattro is designed to have the cushion fill up with air and kind of float on your face. If you tighten it too much it will never seal properly. Ask if they have a resmed softgel nasal mask. The headgear on that is adjusted similar to the quattro but the cushion is different. If they have that give it a try and I bet you don't have leaks.

They probably had you try the Ultra Mirage Full Fave mask didn't they? If so and it was worst, then the quattro will work for you it was just not adjusted or sized properly.

Gerry

As I mentioned in a previous post, theres a design flaw with the Quattro which causes it to leak at the elbow. They say there in the process of redesigning it.

Sorry to read of your sealing issues. I think mask are very unique to the anatomy of the face. Every person face is structered differently. Since I've used the Quattro, my leaks are none to minimal (.06),.

Try adjusting the mask up/down. My leaks were alot higher, when my mask sat higher on my face, the bridge support was across my forehead, I pulled the mask down, till the bridge support is over my eyelashes, and the lower part of the mask is at the top of my chin. Works like a charm.

When I first used the Quattro, DME shared, not to adjust nose bridge while sitting, but to lay down, adjust mask, turn on cpap and tighten nose bridge. She said, lots of people adjust mask and tighten nose bridge while sitting. I don't adjust the nose bridge at all, and my mask seals fine. This may sound strange to some, but I sleep alot on my left side, so my mask is adjusted slightly crooked on my face, to compensate. I do not put my mask on, directly over the center of my face, but slightly towards the left, then when I lay my head down on the pillow, the mask is centered. Hope my description makes sense. My left strap is slightly tighter then my right. I adjusted my mask, while laying down.

Adjustment periods are no fun at all, but worth the effort for complete comfort. Each time, you awaken during sleep, from leaks, try to adjust, prior to going back to sleep. You can also try other FF mask, till you find one your happy with.

That elbow was already corrected. Their are tips on here to fixing that problem yourself but I didn't find it a big problem myself. The new elbow has not leaked for me. It's the swivel part that hooks up to the mask not the elbow. If you have an older mask with the problematic elbow you can order a new one and the problem is fixed.

Gerry

Brian,

Your "problem" may actually be in your BED pillow. Some work better with this therapy than others. With most "standard" pillows, your head sinks in and the ends push your mask out of position.


Den

Brian I did find what Den said about the pillow true for me with the quattro. I have used a memory foam pillow to help prevent this and also used a regular pillow fluffed up and my face near the edge on both. A foam pillow is nice because it is smaller and when I roll over I am in the right position on the other edge.

Before you buy a pillow try adjusting the one you have. I am not completely happy with the memory foam and was thinking of trying a regeneris pillow.

One other thing you can try if you have ever seen or have one of those smaller car pillows, try putting that under your head on the top of your present pillow. That may work too.

Gerry

I have also had good success with a standard-size contoured memory foam pillow. It's just the right size that when centered on my back I can roll to either side and be close enough to the edge to not disturb my mask, sometimes requiring a very minor head position shift, but not always.

That's worked so well that I've been continuing with that old "backup" memory foam pillow despite having replaced my mattress topper and pillow with (pricey) natural latex versions earlier this year. I keep meaning to order a new natural latex contoured pillow in standard size, but the place I favored to order from only has it in queen size, which will be too long and not allow me to shift to either side so easily.

More directly related to the leaks though. I have finally been able to access the data from my machine just today, and discovered that the Large Leaks I'd only recently noticed have somewhat correlated timing beginning from when I screwed up while cleaning my Quattro mask cushion. Normally I wash the cushion daily with warm water only, and rely on the slight abrasion from my fingertips to clean the oils off. This works quite well under running water. Once in a while, I use a little Dawn dishsoap (supposedly it's quite mild) to help get it clean. That seems to work a tad better. About two weeks ago I screwed up and used the soap from our kitchen sink pump reservoir. It's the same color blue as our dawn, but i think there's been other soap mixed in there at times, or it was filled with some other blue soap. I didn't realize there was a problem until things dried. The cushion had a white haze to it and I tried to re-wash it as best I could, which only partially restored the original opacity. The feel of the cushion didn't seem too different, but ever since then, I've had a string of otherwise unexplainable Large Leaks lasting for extended portions of the night. I suspect I damaged it and should buy another. You don't specifically mention any occlusion in your mask cushion, but I'd warn that if you at any time use soap to wash it, pay attention to any opacity changes.

Most directly to your original post: I had a week or so of struggling with leaks into my eyes and out the cheek area early on, and the key that got me past it was a post recommending that once you are lying on your back, pull the mask away from your face until just the point that air starts to come out and then let it re-settle. Variations on that tactic, plus occasionally dipping my index finger under the cushion up near my eye and running my finger under the cushion line following the cushion gap to my mid-cheek, allows me to clear any creases that develop near my nose, usually near the bridge. I have to repeat that several times typically to get it right, but after that, I'm generally good for the night. Hope that might help.

I feel your pain. I actually have to tighten my Quattro so much that it digs into my skin. I've tried having it float, but with my pressure (19) I just don't think it's possible. I tried the Mack's plugs, I'd read about them here, but I can't get them to stay in place. Let me know if you do come up with anything please and I'll do the same Welcome to the site! I'm a newbie too.

Sleepy I was where your at now. I was at 20/16 BiPap with a quattro and had terrible problems. I finally got them worked out but still had problems with leaks. I had such a bad time that my DME called my doc and said they don't know what else to do. That I am wearing the mask and trying everything and anything they can think of but I am still having bad leaks and losing therapy. That's when my doc said she wanted to talk serious about getting my tonsils out. I did and I am doing many many times better. That surgery isn't for everyone and I wouldn't let just any doc do it. But it worked for me and my primary care doc said it save my life.

But it's a last ditch thing to consider.

If you have the leask narrowed down to them coming from the same place perhasp you could talk to padacheek and see if she has any ideas. I belive her name is Karen, but don't take my word on that I have been bad with names my whole life.

Gerry

For me, when I use the Quattro, I found the headgear straps being a bit on the loose versus tight side helped. Then, I turn my machine on ramp where it starts out at a lower pressure. Then I hold the mask off my face and let the cushion fill with air and carefully put it back on my face where it seals best. Sometimes I have to push my finger in here and there to straighten out this pesky soft cushion material that has a tendency to crease.

Best wishes!

Like others have said for me too it's a curious balance of strap tension, forehead adjustment, getting the mask to sit not too low but not too high and then cutting up my foam pillow with a carving knife to make depressions for my mask to sit in so that the pillow doesn't push it around. Lots of trial and error is about all you can do until you figure out that magic formula that works for you. Personally, I'd do all that I could to not have to use as high a pressure as 14 or higher, as at least for me, when I've tried it, I'd have to have my mask strapped on tight, too tight.

Also I shave each night, I wipe my face and mask each night so that they have no oil and then I fiddle with how it sits on my face and sometimes pull out the seal a little here or there, or pull it off entirely and then reposition it (but without pressure on), and then slowly let it fill with air but holding it in place so that it doesn't get blown off, as my machine is set up with a pretty fast pressure ramp.

All in all, once i figured out the Quattro after fighting and almost hating it (though I hated the nasal mask and pillows FAR more), I now really like the Quattro and it works for me most of the time. Now at a year old, the straps seem to have stretched a bit and I think may need replacing before any other part of the mask does, and I probably don't have mine nearly as tight as those that need higher pressures?