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Quattro FX Issues - Seeking Advice
I solicit advice on the use of the ResMed Quattro FX mask. First some background. I started on CPAP Mar 1, 2012 using the S9 Auto with the RM Nasal Pillows mask and have been very successful thus far with an AHI slightly over 1.0 with CA at .6, OA at .3 and Hypo at .3. Usage has been good with median daily use slightly over 7 hours a night, average daily use at slightly over 6 hours a night. Through May 10, I used it more than four hours a night 84% of the time. In May I went on a month long trip to Italy and tried to use the system but caught a cold and was unable to breath through my nose at all so the pillows mask wouldn’t work at all. Since May 10, I missed 13 days using the mask at all and had more nights where I used it less than 4 hours. Prior to the trip and the cold, my only problem with the system was when nasal congestion (especially during allergy season) prevents me from breathing through my nose and I had to take the mask off.

My plan going in was to get the Quattro FX mask as a back up as soon as I was eligible for a new mask which was June 1. Finally got the mask and headgear June 15 and was only able to keep it on for about 2.36 hours with AHI of 1.1. June 16 used it 7.43 hours, AHI 2.3. June 17 3.09 hours, AHI.6. June 18 4.04 hours, AHI .2. June 19, 7.29 hours, AHI of 5.0. June 20 and 21 I switched back to the nasal pillows with good results.

When I use the nasal pillows mask, my pressures are set at 5.8 and 12.6 with EPR set at 2 and full-time and, with the exception of nights with congestion, I got great results. The pressure through the night would go up and down depending mostly on the flow limitation but usually was between 6 and 10 over the course of a night. With the Quattro FX, I noticed that the pressure rose fairly quickly up to the maximum of 12.6 and pretty much stayed up there through the night. This results in a problem when I am breathing through my mouth where the pressure fills my mouth with air and my cheeks blow up like a balloon. This results in the mask leaking and my waking up. So, on June 18, I lowered the top pressure to 10.6 to see if I could breath through my mouth OK. I only lasted 4 hours with a .2 AHI waking up when the pressure was at its highest. The next night, with the top pressure at 10.6 I slept 7.29 hours (was able to control the mouth breathing to a slow intake and exhale preventing the mouth from blowing up) but got an AHI of 5.0 which is by far the worst I have ever had since I started. So I put the pressure back to the 12.6 level and again experienced the mouth blowing up like a balloon. Then I switched back to the pillows mask and returned to my normal good results.

So, the questions are 1) Is it normal for your mouth to blow up like that with a full face mask? 2) Is there a way to stop it from doing that? 3) Is it normal for the pressure to go up to the max and stay there with a full face mask? 4) Has anyone else experienced this kind of result in using the Quattro FX mask? And, 5) Does anyone have any suggestions?

Thank you

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I can tell you that with the same mask when I first open my mouth it feels like it fills with air or as you call it blows up! I usually start with nasal breathing to make sure all the seals are tight.
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This may be of help. I use the quattro also and I had a problem with my jaw dropping and I start to breath through the mouth and in morning felt like I had swallowed a sand storm. I do this to solve my problem. I have a resmed chin strap. I do not use the short velcro back strap, but I fit the chin cup and adjust just to point enough pressure to hold up jaw. I then put the chin strap around my neck to keep it out of the way when I put on the quattro. When the mask is on I take the chin strap and put it on my chin and pull it over my head and the quattro straps enough to hold. Works for me, my mouth stays shut and all is well.

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