Fitting Quattro Air Mask

The Latinist · Post by **The Latinist** » Fri Apr 25, 2014 8:38 am

So last night was my first night of APAP therapy, and everything was great at 10 cmH20; but whenever my machine increased pressure I started to get leaks. Then the machine increased pressure more to compensate for the leaks, and I felt like I was in inescapable feedback loop. This was the only issue I had with therapy last night; I think I probably would have slept through the night if it hadn't been for the leaks. So I need to get this under control.

My mask is the Quattro Air, which I realize is relatively new. The way the cushion works, it really relies on air pressure to inflate the cushion and hold it against the face. When I awoke in the night I kept trying to adjust the straps to stop the leak by making it tighter; but now that I'm more awake I wonder if that wasn't a mistake. Does this type of mask require a looser fit so that the cushion can inflate properly? Maybe I was just making it worse by tightening? How do others go about finding the right fit with this kind of mask? Any suggestions would be welcome.

SleepDisturbed · Post by **SleepDisturbed** » Fri Apr 25, 2014 8:45 am

Use the mask fit option on your machine. Turn that on and then lie down in bed and adjust your mask. The mask fit option will turn the pressure up to your max setting for three minutes. Adjust the mask at that pressure and see if it helps. Twist and turn into your normal sleep positions, try it out!

May take several tries. One thing that helped me was making VERY small adjustments at a time. First few attempts I was making much too large changes.

Good luck!

Pugsy · Post by **Pugsy** » Fri Apr 25, 2014 8:47 am

http://maskarrayed.wordpress.com/taming ... e-quattro/

Different mask but the concept is still the same. It needs to inflate to keep the seal and over tightening limits ability to inflate.

library lady · Post by **library lady** » Fri Apr 25, 2014 9:16 am

This is the mask I was started on, and if I hadn't discovered mask liners I would not have continued with it. I use RemZzzs that I got from a local supplier, but you can also use Pad-A-Cheeks, order both online. You do not want it to be too tight, and the mask fit option does work.

The Latinist · Post by **The Latinist** » Fri Apr 25, 2014 9:34 am

Pugsy wrote:Different mask but the concept is still the same. It needs to inflate to keep the seal and over tightening limits ability to inflate.

That was just what I was thinking this morning. Last night in my sleep-addled haze all I could think to do was keep tightening, which was just the wrong approach. Once I'd woken up and had full use of my faculties I realized that I must be doing it wrong. I'll loosen the top up and refit the bottom with the MaskFit feature tonight. Here's hoping for a better seal!

Juanefny · Post by **Juanefny** » Fri Apr 25, 2014 9:42 am

And sometimes the first mask you start out with is not necessarily the one that will be for you in the long run. I tried the QA for one week since it's the one they had in stock at my local Apria and the leaks kept waking me up at night. with the dolphin noises. I tried everything short of the liners to make it not leak and it was a no go...
I've been using the Simplus since Monday and... what a difference! Aside from some fitting issues the first night, I"m getting phenomenal results. I've heard of others that the simplus just had tons of leaks for. So it depends on your face and what works for you...

The Latinist · Post by **The Latinist** » Fri Apr 25, 2014 9:52 am

Juanefny wrote:And sometimes the first mask you start out with is not necessarily the one that will be for you in the long run.

That's a good point. I'll give it a week or so while I try to get the adjustment right, then see about a different mask if it is still not working for me.

old dude · Post by **old dude** » Fri Apr 25, 2014 10:48 am

I keep the top ( around the forehead) straps a little loose but I'm not afraid to tighten down the bottom straps as necessary. For my face anyway, the "keep the straps loose so the cushion can inflate" advice has been pure bunk. Unless we have different definitions of tight and loose. I've tried every FFM on the market except the most recent ones and the Quattro Air is the only one I can't make leak if I tried to.

Also, make sure you have one that fits. The Air runs one size small, so if you normally take a medium be sure to get a large.

Bottom line, you just have to be willing to invest the money and time trying different masks over and over until one works for you. We all ask for mask advice, myself included, but I don't know why. What works for one person is generally irrelevant to another person. As an example of this trial and error, I use the Quattro Air but immediately discard the junk headgear and substitute a F&P headgear made for their Eson nasal mask. Works great!

echo · Post by **echo** » Sat Apr 26, 2014 6:19 am

old dude wrote:the Quattro Air is the only one I can't make leak if I tried to.

Also, make sure you have one that fits. The Air runs one size small, so if you normally take a medium be sure to get a large.

Hi old dude, The Air runs smaller compared to which masks? What about compared to the Quattro FX? (That also runs smaller compared to the other resmed ffms, if I'm not mistaken?).

And, just wondering what kind of facial structure you have? I've also not had any success with FFMs and I've tried almost all of them! My closet is a mask graveyard!

old dude · Post by **old dude** » Sat Apr 26, 2014 7:53 am

echo wrote:
old dude wrote:the Quattro Air is the only one I can't make leak if I tried to.

Also, make sure you have one that fits. The Air runs one size small, so if you normally take a medium be sure to get a large.
Hi old dude, The Air runs smaller compared to which masks? What about compared to the Quattro FX? (That also runs smaller compared to the other resmed ffms, if I'm not mistaken?).

And, just wondering what kind of facial structure you have? I've also not had any success with FFMs and I've tried almost all of them! My closet is a mask graveyard!

Probably the best comparison on sizing the Quattro Air would be versus the old standby Mirage Quattro. The Air runs a full size smaller than the regular Quattro, and most other FFMs I've tried. I too have a large boneyard of FFM fails. FWIW I find the Quattro FX way too complicated to both clean and use, plus the spring arms continue to ride up into my eyes. Makes me crazy.

frapilu · Post by **frapilu** » Sun Apr 27, 2014 8:59 am

old dude wrote:
echo wrote:
old dude wrote:the Quattro Air is the only one I can't make leak if I tried to.

Also, make sure you have one that fits. The Air runs one size small, so if you normally take a medium be sure to get a large.
Hi old dude, The Air runs smaller compared to which masks? What about compared to the Quattro FX? (That also runs smaller compared to the other resmed ffms, if I'm not mistaken?).

And, just wondering what kind of facial structure you have? I've also not had any success with FFMs and I've tried almost all of them! My closet is a mask graveyard!
Probably the best comparison on sizing the Quattro Air would be versus the old standby Mirage Quattro. The Air runs a full size smaller than the regular Quattro, and most other FFMs I've tried. I too have a large boneyard of FFM fails. FWIW I find the Quattro FX way too complicated to both clean and use, plus the spring arms continue to ride up into my eyes. Makes me crazy.

My facial structure is in a couple of words, big and fat. My ex-wife used to say that I have a head like a 5-gallon bucket. While perhaps a bit harsh, she was not inaccurate. Now this creates a bit of a problem for me in that I really need an extra large in the Quattro Air, which of course isn't made. So I get by with the large by wearing it a bit lower on my nose than most other FFMs (ResMed will tell you it's designed to be worn that way anyhow), and I use a headgear from the F&P Eson nasal mask. I do the latter because the Resmed headgear doesn't have any adjustment for the top of the head strap and it constantly pulls the mask up on my face. Plus, the F&P headgear is light years better than the ResMed one.

To get a good seal with this mask I have to wash the cushion every morning thoroughly with warm water and baby shampoo, as well as wash my face just before bedtime. This regime is non-negotiable for me.

Good luck to you!

The Quattro Air is the same size as the regular Quattro. I've used both and I use xsmall in both.
Below is from the cpap.com webpage:

Sizing Quattro Air For Her: The following sizing information is provided by ResMed

The Quattro Air For Her is approximately the same size as the original Quattro Full Face Mask. A size Extra Small Quattro equates to a size Extra Small Quattro Air For Her.
However, if changing from the Quattro FX Full Face Mask to the comparing the Quattro Air, ResMed suggests stepping up a size. For example, if a Small Quattro FX is used successfully, step up to a size Medium in the Quattro Air For Her.

France.

The Latinist · Post by **The Latinist** » Tue Apr 29, 2014 8:30 am

Following the instructions from the MaskArrayed blog that Pugsy linked to I have been able to adjust my mask pretty well. I was awake almost half an hour after donning my mask last night without any leaks, was not awakened by any leaks in the night. This morning for the first time I awoke to the green smiley face on my S9's screen -- a pleasant sight.

The only problem is my AHI -- it was almost 12 last night after several nights in the 4 range. Now, it's entirely possible that leaks over the last few days have caused the machine to miss events which have only showed up now that I've tamed the leaks. And I haven't got my SD card reader yet, so I haven't been able to look at my detailed data. Perhaps I should wait to look at the data before getting worried...

Pugsy · Post by **Pugsy** » Tue Apr 29, 2014 8:42 am

I don't remember...is there some way of getting the AHI breakdown into event categories on the LCD screen of the S9 AutoSet?
I can't test my S9 Adapt because it doesn't flag centrals separately anyway.

If the AHI is predominately central in nature...we don't want to increase the pressure as an increase could potentially make centrals worse.
If the AHI is predominately obstructive in nature then likely an increase in the minimum pressure is needed.

It's real important to be able to see the event category breakdown in this situation. AHI of 12 over the past AHI of 4 very well could be from the machine now being able to sense and record the events now that leaks are better managed.

If your computer doesn't have a slot for the SD card...getting the card reader should be number one priority...they are cheap...Walmart has them. Doesn't have to be name brand.

The Latinist · Post by **The Latinist** » Tue Apr 29, 2014 8:48 am

Pugsy wrote:If your computer doesn't have a slot for the SD card...getting the card reader should be number one priority...they are cheap...Walmart has them. Doesn't have to be name brand.

Yeah, I have one on order from Amazon. Centrals are a concern of mine, too; during the titration part of my study I had an increase in centrals at around 11 cm H20 that seemed to go away at 12.

Still, even an AHI of 12 is better than my untreated AHI of 95!

The Latinist · Post by **The Latinist** » Wed Apr 30, 2014 5:58 am

Awoke to another green smiley face and an AHI of 5.9. The secret with the Quattro Air was definitely to loosen the top and tighten the bottom. I'll have my card reader tomorrow and will be able to post leak lines and event details. But subjectively I think I'm doing pretty well.

Fitting Quattro Air Mask

Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask

Re: Fitting Quattro Air Mask