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Sensible Advice Required
#1
Hi all,

I'm new to apneaboard, but would like some unbiased advice.

I have been happily using my ResMed S9 Elite and ResMed Fullface Mirage Quattro mask for around 2-3yrs now with no real problems. I went to get the data checked out because I was starting to have issues waking for periods of 2-3 hours during the night and not being able to get back to sleep.

My sleep "therapist" told me there was a major leek in the mask that had been getting worse. Her first solution was to sell me a new mask. When I asked how that would help she couldn't give me a proper answer, just that it was on the way out and it was time to get a new one.

I asked for other alternatives and she ended up selling me a chin strap to stop my jaw dropping. She also said I could replace the seal. I'm desperately waiting for the chin strap to arrive, because ever since she mentioned the leek, psycho-somatic me has been feeling exhausted in the mornings again.

The point of this post is that I don't trust the "therapist" (salesperson). I have downloaded the SleepyHead software and am just about to get an SD card reader to have a look at the data myself.

I wanted to ask others if a chin strap/ replacing the seal has helped or if masks do "wear out"? It seems like a bit of personal preference to me. I have generally had a good seal with my Mirage Quattro up until now, where I may be dropping my jaw.

Thanks for reading
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#2
Welcome to the forum, Sleepy Game

Nothing wrong with advice from the sleep therapist, trial different mask and replace worn out cushion does make sense

You can also check the data yourself, the S9 Elite display AHI and leak information on sleep report

SleepyHead software download link is at the top of the page
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#3
Welcome

Old mask cushions will get leaky when the silicone becomes inflexible. You could try boiling the mask cushion with baking soda. I sometimes boil about a quart of water, add a teaspoon of baking soda, drop it in, and let it sit for about 15 minutes. Then it will be slimy from skin oils which will need to be washed off. (You will probably need a bigger container for the Mirage Quattro.)

Boiling is a good stopgap measure to get a little more life out of a mask cushion. You really need to get a new one, but this gives you some time.

Hope this helps you.
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#4
Accumulate a few spares for mask, tubing, and water tank as soon as your insurance will pay. That way, if you break something, you have a spare, and you can switch items if you think there's a problem with one of the items. You can also clean one set of parts and let the clean ones sit dry for a while to keep down germ growth.

Once you've accumulated enough spares, only buy replacement parts when you need them.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#5
Hi Sleepy Gamer,
WELCOME! to the forum.!
You might get an extra cushion, unfortunately, they do wear out from time to time.
Hang in there for more suggestions and best of luck to you.
trish6hundred
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#6
Hi SleepyGamer,

aren't you using some software to check your therapy?
In this case you should very easy see any kind of leak or other problems.
Otherwise you're "flying blind", so i definitely recommend using some software like "SleepyHead".

I'm also using the ResMed S9 with a full face mask, and i'm looking for a better mask, because i'm a "side sleeper". So i have a lot of leaks every night Sad
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#7
The ResMed Mirage Quattro is my favorite mask. Getting the right mask can be one of the most difficult things when beginning CPAP. We are all different.

That said, the mask frame seldom needs to be replaced as long as the anti-asphyxia flapper-valve remains in good order. (The likely failure mode for that is to just break away; and I've never seen it fail.) I use a frame for a long time; and replace the mask cushion often. I also replace the headband often.

A chin strap is a necessary for many people to "Pavlov" the person into keeping the mouth closed.

By all means, get that SD card reader and start looking at your data. SleepyHead reports the sum of intentional leak (through the vent holes) and the unintentional leak. ResScan knows the mask versus pressure curve for the mask vents and reports only unintentional leaks.
(Provided the type of mask is properly set in the menus.)

The redline for unintentional leaks is 24 LPM. Above that the machine cannot keep up... and therapy and data become unreliable.

[Image: pBt22Od.jpg]
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#8
Given that your sleep therapist said, "there was a major leek(sic) in the mask that had been getting worse", you should do something about it. First off, get the free software offered on this site and see for yourself what the leaks are measuring and whether or not they are high enough to be affecting your treatment. Let's face it, if the leaks are at such a high level as to render your treatment ineffective, then you're going through all the inconvenience of wearing a CPAP mask for nothing.

If your mask is more than a year old, as you have stated, you're way overdue for a cushion replacement. The Mirage Quattro is a good quality mask but it doesn't last forever. If the hard parts are still in good shape, then replacing the cushion and possibly the headgear (the strap) will bring it back to the performance level of a new mask. The cushion is available for 50 bucks +- and that's where you should start. Check the headgear for its ability to stretch at least 2" when tugged firmly from end to end. If its still that flexible, then it'll be OK to use unless you can see that it's frayed and in danger of breaking. Frankly, any fool (me for example) can tell by the general appearance if the headgear need replacing but the stretch test will confirm that.

Since you know that your jaw is dropping down during the night, do as I do, open your mouth slightly (or even more so) before installing the mask to your face. That alone could help the mask maintain a better seal all night long. Having a major leak, as you have been told, will usually made enough whistling or farting noise to wake you up. Getting back to sleep after that can be a problem since your subconscious mind is telling you to get out of bed, you've slept enough. In this case the subconscious mind is mistaken.

A chin strap will only work if you are fully able (at all times) to breathe comfortably through your nose. If you have a tendency to be a mouth breather due to some nasal problem that isn't temporary or easily fixed, then forget the chin strap and work around the problem as I have suggested by using a full-face mask (as you are doing) and dropping the chin slightly when installing the mask.

Bottom line is, don't blame the messenger, get that new cushion and be thankful that someone pointed out that you needed it.

I will add that mask liners are great for people who have hard to fix leakage problems. You can buy them or make your own out of soft cotton. It's not rocket science and it works very well. I make mine from my old tee-shirts that have been discarded because Mrs. surferdude says they need to be in the rag box. I made my own template and cutting them out is quick and easy. I may buy some professional ones someday if I expect company and want to show off but in the meantime these home brew ones are doing just fine.
oldman
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#9
BTW, I've found a great price for that Quattro cushion right now. They're normally in the $50 range but I found them for $29.02 shipping included - Google Resmed Quattro seal - Amazon for details. I think I'll get a spare since the price is right.
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#10
Pretty much covered above:

Get the card reader, download the software, look at your number each day (for a while.)

Pay particular attention to your leak rates and AHI.

If the leak is normal (all masks leak SOME or you couldn't exhale) then enjoy the mask as long as it is comfortable for you.

If you have insurance, most companies will pay for a new one every 3 or 6 months.

IF you can breath through your nose and keep your mouth closed then consider buying a Resmed Airfit P10.

It is the most comfortable mask for the largest percentage of people.

You really can't get the best therapy unless you monitor you on numbers day to day at first and then at least week to week when things stabilize.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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