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Review of three ResMed Masks - Mirage Micro (nasal mask), Mirage Quattro (full-face mask), and Mirage Swift II (nasal pillows)

I'm new to CPAP, and have been using my ResMed AutoSet II for just under a month. Before I started with CPAP, I researched the various types of masks available, which fall into three categories-- nasal masks, full-face masks, and nasal pillows.

During the last three weeks, I've had the opportunity to try each of these three types. Here are my impressions of each.

Mirage Micro Nasal Mask

This was the first mask I used, and it works well for me. I'm able to fit it without leaking much, but I have to have it pretty snug. When it's tight enough not to leak at all, I end up with red marks across the top of my nose, which generally go away within a few hours after waking. But if the mask is really tight, the redness doesn't go away. I've also developed some skin irritation on the sides of my nose.

Overall, though, this mask is comfortable, and I'm able to work my glasses on to read with the mask on. The hose has a quick-connect, so I can pop off the hose, and leave the mask on, if I need to get up during the night.

The biggest problem I have with this mask, really is not due to the mask itself. My nose gets stuffy, due to year-round allergies and though I've been using Nasonex a few times a week and it helps, there are nights when I wake up with my nose blocked enough that breathing with the mask is difficult. I've managed to get through the night in spite of this, though.

For this reason, I thought that a full-face mask might help. I figured that, on the nights when my nose was really blocked, I could use the full-face, and resort to breathing through my mouth.

Mirage Quattro full face mask

This one I just did not like at all, right from the start. It's big and bulky, and during use it felt like it was blowing my cheeks out, which became uncomfortable.

It was easy to adjust, and didn't seem to leak much. Like the Mirage Micro, it also has a quick-connect for the hose.

I tried using it for an hour or so, but gave up on it. I'll save it as a backup, and will probably end up using it when I have a cold, since the nasal mask will be worse. Otherwise, it’s definitely not my favorite choice.

Mirage Swift II Nasal Pillows

The sleep center where I did my titration study does not reuse masks. They use a brand new one for each patient, and give the mask to the patient to take home. I was curious to try something different, and when I found out they had the nasal pillows, I figured I'd see how I liked it.

I like that this type is lighter, and allows me to wear my reading glasses easily. I like reading before I sleep, so this was a big plus. I also like that I don't get the red marks that I do with the nasal mask. It's more compact, so will be better to use when travelling.

But I wasn't all that thrilled with it. It does not have a quick-connect, but it is easier to put on and take off, so that's not a majro drawback.

The air flowing through it felt a lot warmer than with the other masks, and the nose piece had an odd smell which was a bit annoying. Because of the design, I find that it leaks more than the other two, and seems to shift and leak as I move around, much more so than the nasal mask.

I also find that air flows through the exhaust ports at a higher volume than with the other two, so it's noisier. The first night that I used it, my leak amount was much higher than with the nasal mask on its worse night.

It might be that my ResMed AutoSet II, which has a setting for the mask type, mistakenly reported the high leak rate because I didn't change the mask setting to tell it I was using the nasal pillows. If I had changed that setting, the AutoSet might have been able to account for the higher exhaust flow, and my leak rate may have been reported more accurately. I'll try setting the mask type properly, and see if it makes a difference.

In spite of the negatives, though, I was very comfortable using it during the first and second nights. The warmer air didn't feel so warm, and the smell was less noticeable. During the second night, I woke and could not tell if the CPAP was on, so it really was comfortable once I got used to it.

So, my overall opinion?

My favorite is the Mirage Micro nasal mask, but because of the nose irritation, I'll end up alternating using the Mirage Swift II nasal pillows for a few nights in a row, to give my nose time to recover. And I'll keep the Mirage Quattro full-face mask as a backup for when I have a cold or my allergy is really bad.

What I do recommend is that every CPAP user try out different masks. Ask, or insist if necessary, that your DME provider give you an opportunity to try at least two. If you have several sleep labs in the area, you might try visiting them, and see if you can try on a few masks to compare them.

ResMed has a 90-day warranty on their masks, and I was told that they will exchange any mask during the first 30 days. You may find that your DME provider is willing to have you try a few, especially if you remind them of the warranty.

If you have more than one sleep center in your area, you might consider a "tour" of each one. There is a new sleep center where I live, and they are very interested in gaining new patients, so when I visited them and told them I was considering a new sleep center, they were willing to take some time with me. They also are a DME provider, so they were very accommodating and showed me a few different options.

CPAP is one of the best treatments for sleep apnea. It's important that you keep trying different masks until you find the best one or two that work for you. Don't let an uncomfortable mask, or uncooperative DME provider, keep you from experiencing the benefits of CPAP!

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Comment by Judy on January 28, 2010 at 2:04pm
If the Liberty doesn't work for you, MaryZ, consider trying the ProBasics Zzz-Mask. It is a full face mask. The headgear will most likely be too big for you but some experimenting w/putting a fold in any strap that is too long and holding the fold in place w/velcro until you find "the" right fit, then cutting the fold out w/scissors and putting the cut ends back together w/velcro. This has worked great for me.

The Zzz-Mask is lightweight, there is no forehead piece. I can actually sleep on my sides and roll on my back w/o dislodging it and do NOT have to have it too tight for comfort. I can hang my hose over the head of my bed to reduce the tugging of the hose on the mask, or I can take the hose under the covers w/me to avoid the risk of "rain out". AND, as proven night before last via an in-lab bi-level re-titration my Leak rate is zero!

I actually prefer the Zzz-Mask to my beloved Simplicity simple nasal cushion or the Swift LT. The headgear was the only challenge and I encountered that same "challenge" w/the Simplicity headgear and "fixed" the headgear in the same way: fold, velcro; scissors, velcro.
Comment by a a pearson on January 28, 2010 at 12:10pm
Thank You for letting me know about the warranty on res med. I try a mask and ask if i can change it realy dont work for me and they say next time you can try a mask is 3 months when ins will ok it, or I can pay for it outright. Its so irritating. I just gave up.
Comment by Julie Camacho Monzon on January 28, 2010 at 11:37am
Like Judy I also use the Swift LT (for Her). I tried attaching the hose on my head strap, it was comfortable but it gave me a headache in the end. It's better than the first mask I had which was also with nose pillows. The only problem I have is that I tend to break out on my face where ever the mask is secured.
Comment by Steve Benedict on December 28, 2009 at 5:11pm
I'm using the Mirage Liberty, and I like it a lot! Sometimes the nose pieces get slippery and leak a little, which wakes me up. But it's easy to take a tissue and clean my nose and the pillows. I slip it back on and am sleeping again within 15 minutes. I am a mouth breather and this is a great compromise. I did have to experiment with nose pillow sizes, but...all in all..I really like this hybrid. Disclaimer: I ain't getting paid a damned dime to push the mask!
Comment by Judy on November 16, 2009 at 4:13pm
There is a foruth type of mask that you might want to consider in place of the Quattro, Andy. And that is the Liberty that Mary just mentioned. It is a "hybrid" style mask, i.e. it has both nasal pillows like the Swift II but it also has a mouth cushion so that you can breathe thru your mouth as well when congested and stuffed up. There is also a "hybrid" called the Hybrid. Whether there is another model of hybrid I can't say as I've never tried any of them myself.

And you might well find the newer Swift LT more to your liking than the Swift II. I HATED the original Swift due to the asinine hose attachment on the side(s). The Swift LT has the more sensible hose attachment in the center of the mask, the swivel swings very free and easy - AND - you can run the hose up above your head which makes for LESS tugging of the hose on the pillows when you move and change positions during sleep meaning less Leaks. I like the Swift LT quite a lot.
Comment by Mary Z on November 16, 2009 at 2:40pm
Andy, thanks for your input. I am a mouth breather and use the Mirage Quattro full face mask and have a chronic problem with redness and irritation on the bridge of my nose, despite RemZzzs and bandaids. I'm going to try the Mirage Liberty next. Hope to get one by the end of the week. I have to pull the Quattro so tight it leaves other marks on my face, but these usually go away. The nose breakdown is not ok and I understand it's a problem with a lot of masks. I don't let any of it stop me from using my CPAP, but my DME will help me find a remedy, hopefully the Liberty.

Mary

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