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Quattro air FFM leaking
#1
I had been using the Small Quattro FX FFM, but was having leaks(on Sleepyhead, not registering on my machine) and high AHI's. I have used the Quatrro Air FFM for 4 nights and have had 16% leaks show on my machine which was always 0 before. The odd thing is I can feel the leaks on my chin, try to readjust and go back to sleep but the pressure is registering much lower than before. With the FX, I used to awake and ramp down to go back to sleep. Now the pressure doesn't change so it must be at the lowest of the auto setting at 5. If I'm leaking, wouldn't the pressure be high as to compensate? Totally confused by these results.

Quattro Air FFM
Philips Respironics
System One 560P
RemStar Auto with A-Flex
Mode: APAP 5-16cmH2O
Date Sleep Wake Hours
5/15/2014 00:25 07:42 07:16:22
AHIApnea / Hypopnea Index 3.57
HypopneaHypopnea 2.06
ObstructiveObstructive Apnea 1.37
Clear AirwayClear Airway Apnea 0.14
RERAResp. Effort Related Arousal 2.06
Flow LimitFlow Limitation 0.55
VSnoreVibratory Snore 0.00
PB/CSRPeriodic Breathing 0.55%

Event Breakdown

Statistics
Channel Min Med 95% Max
PressurePressure (cmH20)
W-Avg: 5.60 14.50 5.00 7.00 9.20
Minute Vent.Minute Ventilation (L/min)
W-Avg: 4.49 0.12 4.00 8.62 22.25
Resp. RateRespiratory Rate (breaths/min)
W-Avg: 13.28 6.88 13.20 16.00 17.60
LeaksLeak Rate (L/min)
W-Avg: 10.91 0.00 2.00 41.00 59.00
Total LeaksTotal Leak Rate (L/min)
W-Avg: 40.39 22.00 35.00 71.00 87.00
SnoreSnore (unknown)
W-Avg: 0.00 0.00 0.00 0.00 0.00
Insp TimeInspiratory Time (seconds)
W-Avg: 2.56 0.66 2.46 3.46 7.66
Exp TimeExpiratory Time (seconds)
W-Avg: 1.99 0.26 2.00 2.66 3.40
Tidal VolumeTidal Volume (ml)
W-Avg: 339.07 13.33 300.00 680.00 1680.00

Machine Settings
Pr. ReliefPressure Relief None
HumidifierHumidifier Setting x3

Quattro FX FFM
Philips Respironics
System One 560P
RemStar Auto with A-Flex
Mode: APAP 5-16cmH2O
Date Sleep Wake Hours
5/8/2014 00:16 06:28 06:10:37
AHIApnea / Hypopnea Index 12.79
HypopneaHypopnea 1.30
ObstructiveObstructive Apnea 7.45
Clear AirwayClear Airway Apnea 4.05
RERAResp. Effort Related Arousal 2.43
Flow LimitFlow Limitation 0.32
VSnoreVibratory Snore 0.16
PB/CSRPeriodic Breathing 0.00%

Event Breakdown

Statistics
Channel Min Med 95% Max
PressurePressure (cmH20)
W-Avg: 4.52 4.00 5.00 10.30 11.50
Minute Vent.Minute Ventilation (L/min)
W-Avg: 3.88 0.12 3.75 6.12 14.75
Resp. RateRespiratory Rate (breaths/min)
W-Avg: 12.50 2.97 12.80 15.20 17.60
LeaksLeak Rate (L/min)
W-Avg: 4.65 0.00 0.00 23.00 27.00
Total LeaksTotal Leak Rate (L/min)
W-Avg: 33.76 18.00 24.00 67.00 71.00
SnoreSnore (unknown)
W-Avg: 0.09 0.00 0.00 1.00 3.00
Insp TimeInspiratory Time (seconds)
W-Avg: 2.91 0.60 2.52 6.32 13.40
Exp TimeExpiratory Time (seconds)
W-Avg: 2.05 0.06 2.06 2.66 3.18
Tidal VolumeTidal Volume (ml)
W-Avg: 310.13 13.33 280.00 580.00 1314.18

Machine Settings
Pr. ReliefPressure Relief None
HumidifierHumidifier Setting x3
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#2
pressure does not increase because of leaks. the air volume delivered will vary, to keep the pressure the same.

all masks leak, there's the built in leak from the vent holes, and then there's leaks around the mask face interface, (which hopefully, are zero), plus, the leak rate varies with perssure, high pressure, more liters/minute goes out the vent holes.

the machine compensates for that, by pushing enough lpm to give you whatever your set pressure is.
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#3
Try a mask liner to help with leaks. I used a "pad-a-cheek" liner with my Quattro Air.
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#4
Hi spc23,
I don't use a full-face-mask, (FFM,) but hang in there for more suggestions, best of luck to you with your CPAP therapy and WELCOME! to the forum.!
trish6hundred
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#5
(05-17-2014, 11:59 AM)retired_guy Wrote: Try a mask liner to help with leaks. I used a "pad-a-cheek" liner with my Quattro Air.

thanks. I did use "pad-a-cheek" and also tried a remzz, with no better results. Thinking maybe DME gave me wrong size. I brought the template in but he just tried the small on me and said it was right. Of course in office, it didn't leak. It's when I'm sleeping, laying on my back, which triggers my apnea, which then wakes me and I can feel the air on my chin leaking. I try adjusting, then turn on my side, go back to sleep only for the whole process to begin again.
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#6
(05-17-2014, 11:38 AM)diamaunt Wrote: pressure does not increase because of leaks. the air volume delivered will vary, to keep the pressure the same.

all masks leak, there's the built in leak from the vent holes, and then there's leaks around the mask face interface, (which hopefully, are zero), plus, the leak rate varies with perssure, high pressure, more liters/minute goes out the vent holes.

the machine compensates for that, by pushing enough lpm to give you whatever your set pressure is.

In the FX mask I would ramp down and feel and hear an immediate reduction but with the Air, I can feel the air leaking from the bottom and when I ramp down there is no change in air flow. If I am on my back, sleeping, then having apnea, which wakes me, why is the pressure low? Seems like with auto setting, the pressure should increase to open the airway???


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#7
As you might know, the Air has been updated to become the F10. The difference is that the mask's upper level forehead support has been moved to the mid-point on the mask, creating a better seal. I sure wish there were a "TRADE-IN & UPGRADE OPTION" for existing Quattro Air users, but the headgear and frame are different (cushions are the same).

You could try doing what some have done and make your own mid-level support using an athletic headband or something. I've even tried moving the straps from the top to the point between the frame and the cushion. It actually worked to simulate an F10 experience. But the biggest leak reduction came when I went off AUTO mode. Those big pressure changes seemed to cause leaks and discomfort for me.

(05-17-2014, 10:11 AM)spc23 Wrote: I had been using the Small Quattro FX FFM, but was having leaks(on Sleepyhead, not registering on my machine) and high AHI's. I have used the Quatrro Air FFM for 4 nights and have had 16% leaks show on my machine which was always 0 before. The odd thing is I can feel the leaks on my chin, try to readjust and go back to sleep but the pressure is registering much lower than before. With the FX, I used to awake and ramp down to go back to sleep. Now the pressure doesn't change so it must be at the lowest of the auto setting at 5. If I'm leaking, wouldn't the pressure be high as to compensate? Totally confused by these results.

Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#8
(05-17-2014, 02:34 PM)spc23 Wrote: If I am on my back, sleeping, then having apnea, which wakes me, why is the pressure low? Seems like with auto setting, the pressure should increase to open the airway???
I've found PR's "clinically proven algorithms" to be much less than perfect (for me anyway). Changes in AUTO mode occur at a snail's pace and in too small increments (except for the BiPAP SV of course). Also, my machine seemed to wait for several events to occur before reacting. I'm not that intelligent, but I would certainly be able to program that machine in a more supportive way. I wish there were a whole lot more competitors in the CPAP machine market and then a whole lot more in-depth comparisons (like something done by Consumer Reports) to really get into the real-life results of these machines.

(Opps, wish there was a delete posting option. Meant to combine this with my above thread. Dummy me. Sorry.)
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#9
I tried the Quattro FX and never could get it to stop leaking. Right now I'm using the Simplus, but really want to try the AirFit F10. I agree with WUT about the big pressure changes causing problems for some people.

Your leak rate max is pretty high, so you need to work on those and then maybe raise the bottom pressure a little.

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#10
It may be that you need a larger mask but most of my patients switching from Quattro FX to Air use the same size.

I have had some patients open their mouth fairly wide at night which exceeds what the mask can cover. If this happens, 3 possible solutions:

1) Tighten the bottom strap.
2) Go to the next size up.
3) Use a chinstrap with your FFM (half of the chin cup under chin and half under mask).


I've had all 3 work for different patients.
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