Moderated Chat: ResMed to Discuss the New Mirage Vista™ Mask

With ResMed's Kevin Plihal

ResMed's Kevin Plihal joined us to discuss the Mirage Vista™ mask system on Tuesday October 15, 2002 at 9:00pm eastern time. Scheduled for release in mid October, this new mask offers all the benefits of Mirage cushion technology with a small frame design that allows patients to wear eyeglasses. It's a great mask for those who like to read in bed and those who prefer masks that do not rest high on the nasal bridge.

Kevin Plihal, Senior Product Manager of Masks and Accessories, has a Bachelor of Science degree and is a Registered Respiratory Therapist with more than 10 years of experience in the hospital and home environment.

ResMed is a leading respiratory medical device manufacturer, specializing in products for the diagnosis and treatment of sleep disordered breathing (SDB). When ResMed was formed in 1989, its primary purpose was to commercialize a treatment device for obstructive sleep apnea (OSA), a major subset of SDB. Since 1989, ResMed has maintained its focus on SDB, which is gaining greater public and physician awareness.

Questions

1. What is the difference between the Mirage Vista™ and the Ultra Mirage™ that I have been using?
2. What patients are best suited for this new mask?
3. Why is the new Vista recommended for first time users?
4. Is this a good mask for women or patients with small faces?
5. It appears you have removed the forehead piece; doesn't this affect the fit and performance of the mask?
6. Are the side panels adjustable?
7. Does the Mirage Vista adjust for patients with different facial structure?
8. Will the new Mirage Vista work with the AutoSet T™ or AutoSet Spirit™?
9. What sizes does the Mirage Vista come in?
10. The headgear looks unusual. Is it as comfortable as the Ultra Mirage headgear?
11. What makes this compact mask better than the others?
12. Can I use the Mirage Vista with other CPAP devices?
13. How long should the Vista mask last under normal wear and cleaning?
14. What are the preferred cleaning instructions for the Mirage Vista?
15. Is the new headgear washed in the same manner?
16. Can I wear glasses with the Vista mask?
17. What do you mean . . . Set & Forget Headgear?
18. How does the Fit Angle Selector work?
19. What is the headgear made out of?
20. I have a rather wide nose, will the new Mirage Vista fit me?
21. Do you plan to release any other cushion sizes after the wide?
22. If I start with a standard size cushion and decide a wide would be better, can I purchase that separately when it's released?
23. Will it fit the frame I've already purchased?
24. I really like the looks of the new Mirage Vista mask, but I am a bilevel user. Will the new Mirage Vista work with bilevel machines?
25. I have a mustache, and have had trouble getting a seal with other nasal masks. Is the new Mirage Vista suitable for patients with facial hair?
26. I usually get up to use the restroom several times during the night. Is there any quick release mechanism to make dealing with the mask easier?
27. I have claustrophobia and find it difficult to wear any mask for more than a few minutes. Will the new Mirage Vista help?
28. It seems like a contradiction. The cushion is soft and flexible, while the headgear is harder and rigid?
29. I have been using an Ultra Mirage mask for nearly two years, should I switch to the new Vista? Why or why not?
30. When I got my last mask, I watched a videotape on fitting, cleaning, and assembling the mask. Is there a similar video for your new mask?
31. Your Web site mentions a "Quick Connect Cushion." What's that?
32. How soon can I see one of these?
33. Does the headgear need to be replaced periodically?
34. What is the best way to adjust the headgear for a proper fit? Most home healthcare companies fit while the patient is standing. Isn't it better to fit while lying down in bed?
35. Other masks have given me sores on the bridge of my nose. Will the Mirage Vista do the same?
36. Is this mask better than the Mirage or Ultra Mirage masks?
37. If I buy a Mirage Vista from an online vendor, what size should I order? I use a standard Ultra Mirage right now.
38. I don't have a homecare provider. Can I order a mask directly from your Web site? And do I need a doctor's prescription to do so?
39. You said the mask needs to be cleaned at least once a week. Do I have to disassemble it every time?

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Answers

1. What is the difference between the Mirage Vista™ and the Ultra Mirage™ that I have been using?

The Mirage Vista has a completely new frame and headgear design. It includes the Set & Forget Headgear, which eliminates the need for a forehead support structure, a Fit Angle Selector to provide an optimum seal, and the One Snap Elbow that allows patients to quickly connect and disconnect from their flow generator. While wearing the Mirage Vista, the patient has the ability to wear glasses.

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2. What patients are best suited for this new mask?

The Mirage Vista is really designed for all patients. Patients new to masks and CPAP therapy will find the Mirage Vista very user friendly. Vision-impaired patients may wear their glasses with the mask, and patients with claustrophobia or dexterity problems will like the openness of the mask and its large easy-to-use headgear clips.

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3. Why is the new Vista recommended for first time users?

Since the Vista has fewer parts, it is easy to set up, adjust, put on, and clean-tasks that may seem daunting to new users. User-friendly features such as the Set & Forget Headgear, One Snap Elbow, and easy-lock parts make assembly very simple. Combined with the proven Mirage® cushion technology, the Vista provides excellent performance along with long-term comfort. And for patients that may feel a bit claustrophobic, the elimination of the forehead support makes the mask less obtrusive and provides a feeling of freedom and openness.

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4. Is this a good mask for women or patients with small faces?

Early customer feedback indicates that women prefer the new Mirage Vista mask to their current mask due to its smaller size and unobtrusive design. Contact your local homecare dealer for a demonstration.

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5. It appears you have removed the forehead piece; doesn't this affect the fit and performance of the mask?

We have removed the forehead support. Our goal for the new Mirage Vista was to create a mask smaller in size, easier to use and adjust, and less obtrusive for the patient. The new headgear design and the side Stabilizing Panels achieved the fit goals. The side panels provide a larger and more stable frame connection, allowing the removal of the forehead piece without sacrificing mask seal and performance.

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6. Are the side panels adjustable?

With the addition of the Fit Angle Selectors on the headgear, each side has five possible adjustments, allowing an exact fit and minimizing mask leaks. The fit has actually been enhanced, and by removing the forehead piece, a potential site for skin irritation has been eliminated.

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7. Does the Mirage Vista adjust for patients with different facial structure?

Absolutely! The Mirage Vista's Fit Angle Selector allows each side of the mask to be adjusted independently for a precise fit. With 5 angle positions on each side, there are a total of 25 fitting positions available.

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8. Will the new Mirage Vista work with the AutoSet T™ or AutoSet Spirit™?

Yes, the Mirage Vista has been tested and validated for use with both of these devices. Simply select the "standard" mask selection in the clinician menu for both devices.

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9. What sizes does the Mirage Vista come in?

The Mirage Vista is currently available in "standard" and "deep" sizes. The standard size is designed to fit a broader patient population than the standard Ultra Mirage. Combined with the deep cushion, the Mirage Vista should fit approximately 80% of all patients. A "wide" cushion size is in development, and it will address the majority of the remaining patients.

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10. The headgear looks unusual. Is it as comfortable as the Ultra Mirage headgear?

Yes, it is quite comfortable. It can be put on and taken off like a hat, and with its Set & Forget Headgear, it never needs readjustment. The Stabilizing Panels on each side help reduce the pressure placed on the face and negate the need for any forehead adjustment or straps. In this case, the unusual look actually improves usability. There are no more loose straps to keep track of, and no more Velcro tabs to attach themselves to hair or clothing. It's extremely easy. Just place the headgear on your head and clip the mask to headgear.

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11. What makes this compact mask better than the others?

Usually, there is a compromise in mask performance to achieve a small or compact size. However, the Mirage Vista gives the benefits of a compact mask with the long-term comfort and performance you expect from a ResMed mask. By designing new headgear and eliminating the forehead support, the Vista provides a an unobstructed view, and the feeling of openness won't cost you the performance you need for effective therapy.

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12. Can I use the Mirage Vista with other CPAP devices?

If you are using an autotitrating device not manufactured by ResMed, you may want to contact that manufacturer to ensure compatibility.

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13. How long should the Vista mask last under normal wear and cleaning?

The life expectancy of your mask depends upon how well it is maintained. Routinely washing with pure soaps and avoiding direct sunlight will prolong its useful life. Should any component of your mask system fail, replacement parts are available through your local home care provider.

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14. What are the preferred cleaning instructions for the Mirage Vista?

It is important to wash all mask systems routinely to optimize both performance and product longevity. Ideally, all mask components should be hand washed at least weekly, or more often if you have oily skin. Use lukewarm water and pure soap to wash your mask components and headgear. Rinse with clean tap water and dry out of direct sunlight. Do not use soaps with antibacterial, moisturizing, or scented additives as these may reduce the useful life of your mask.

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15. Is the new headgear washed in the same manner?

Yes, the headgear should be washed in the same manner. In fact, we suggest that you wash the headgear prior to first use.

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16. Can I wear glasses with the Vista mask?

Yes you can. The new Set & Forget Headgear eliminates the need for a forehead support mechanism, allowing users to wear their glasses if necessary. This was a request we received from a number of customers, including a few attendees of this chat room, so we made it a mandatory design element for this mask system.

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17. What do you mean . . . Set & Forget Headgear?

The Set & Forget Headgear is revolutionary. Once an appropriate cushion size is determined, the fitting begins. The bottom and top straps are adjusted to provide a snug mask fit, and then the mask angle is adjusted to eliminate leaks at the nose or upper lip. The mask is now fit or "set." The "Forget" aspect is based on the headgear clips. They allow you to take the mask on and off repeatedly without affecting the fit. Many masks require some degree of refitting every time a mask is removed.

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18. How does the Fit Angle Selector work?

The Fit Angle Selector helps to distribute the mask pressure more evenly on the face and eliminate leaks. If the mask is too tight on the bridge of the nose, or leaks onto the upper lip, simply tilt the mask angle down. Conversely, if the mask is too tight on the upper lip or leaks into the eyes, tilt the mask angle up. With 25 unique angular positions, the Mirage Vista can be used on patients with fit problems or asymmetrical faces.

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19. What is the headgear made out of?

The Mirage Vista headgear is made out of Breath-o-Prene™, the same material used for the headgear of our Ultra Mirage and Mirage Full Face Masks. Breath-o-Prene does not contain neoprene, and it works as a wick to pull moisture away from your skin during sleep. By pulling that moisture away from your skin and allowing more air to circulate, you are more comfortable and enjoy a better nights sleep.

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20. I have a rather wide nose, will the new Mirage Vista fit me?

The Mirage Vista comes in two sizes, standard and deep. The standard size is designed to fit approximately 60% of all patients. The standard size cushion is slightly wider than the Ultra Mirage cushion. Your local homecare provider can utilize ResMed's sizing templates to determine the correct mask and cushion size for you. We will be releasing a wider cushion size in the near future, so if the standard size does not work for you, ask your homecare dealer about the wide cushion when it's released.

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21. Do you plan to release any other cushion sizes after the wide?

No, not at this time, but we're always listening to the needs of our customers. If there is a need for an additional size, we'll definitely consider it.

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22. If I start with a standard size cushion and decide a wide would be better, can I purchase that separately when it's released?

Yes, as with all ResMed mask parts, the cushion will be available separately.

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23. Will it fit the frame I've already purchased?

Yes, each line of nasal masks (Mirage, Ultra Mirage, and Mirage Vista) comes in one frame size and multiple cushion sizes. A Mirage Vista frame fits every Mirage Vista cushion size; however, it does NOT fit Mirage or Ultra Mirage cushions.

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24. I really like the looks of the new Mirage Vista mask, but I am a bilevel user. Will the new Mirage Vista work with bilevel machines?

Yes, the Mirage Vista was designed to work with both CPAP and bilevel devices within a pressure range of 4 to 25 cm H2O.

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25. I have a mustache, and have had trouble getting a seal with other nasal masks. Is the new Mirage Vista suitable for patients with facial hair?

All masks in the Mirage mask family use a double-layer cushion to enhance patient seal. The outer layer is a very thin membrane, which typically seals quite well with a mustache. If you do experience any leak, the Fit Angle Selector may be used to adjust the cushion in closer to the top lip to improve the seal.

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26. I usually get up to use the restroom several times during the night. Is there any quick release mechanism to make dealing with the mask easier?

Yes, the new Mirage Vista mask incorporates two such features. The first are the headgear clips used to connect the mask frame to the headgear. However, I recommend using the new One Snap Elbow. To disconnect from your flow generator, simply squeeze the sides of the elbow, and pull it from the mask frame. You are now free to get out of bed and use the restroom. Reconnection is just as simple. Simply press the elbow back onto the frame. An audible snap indicates the connection has been made. This feature eliminates the need to remove the mask and headgear.

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27. I have claustrophobia and find it difficult to wear any mask for more than a few minutes. Will the new Mirage Vista help?

It may. The Stabilizing Panels on the new Vista headgear allowed us to eliminate the forehead support arm and encompassing headgear found on most mask systems. The elimination of this structure along with a reduction in mask frame size should help by providing a better field of vision and a feeling of openness. To help you adjust to wearing the mask, try holding the mask frame and cushion over your nose a few minutes at a time. Gradually build up your tolerance to this and then try attaching the mask to the headgear (without the elbow and tubing attached). Again, increase the time you wear the mask and headgear. Once you become more comfortable wearing the mask and headgear, you are ready to connect to the flow generator.

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28. It seems like a contradiction. The cushion is soft and flexible, while the headgear is harder and rigid?

While it seems a bit of a cliché, the system is soft where you need it, and it provides strength and support where you need it. The uniquely designed soft cushion floats on the face to provide an optimal seal and optimal comfort. The headgear straps are soft and pliable. The more rigid pieces are located in places that do not come into contact with a patient's face. Stabilizing Panels are only a millimeter thick and are separated from the skin by a layer of Brethe-O-Prene. The stiff side panels provide added support to the mask frame and minimize the amount of undue pressure exerted on the face to get a good seal.

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29. I have been using an Ultra Mirage mask for nearly two years, should I switch to the new Vista? Why or why not?

If you are happy with the fit and performance of your Ultra Mirage, there may be no need to change to the new Mirage Vista mask. However, if you have difficulty assembling and cleaning your existing mask, and if you wear glasses, switching to the Vista would be a logical choice. Speak with your homecare dealer. They can help you decide which mask is best for you.

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30. When I got my last mask, I watched a videotape on fitting, cleaning, and assembling the mask. Is there a similar video for your new mask?

Yes, ResMed believes these videotapes help both home healthcare providers and patients understand the proper fitting, cleaning, and care of their mask systems. With proper cleaning and care, your mask will last for some time. And with appropriate fitting, you will be more comfortable wearing CPAP, and your therapy will be more effective. The Mirage Vista video will be available soon.

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31. Your Web site mentions a "Quick Connect Cushion." What's that?

The Quick Connect Cushion feature eliminates the need for a cushion clip and simplifies reassembly. This is a great feature when you have to reassemble your mask after cleaning. The Quick Connect Cushion feature makes this Mirage cushion easier to attach to the mask frame than the other Mirage cushions. Simply place the cushion on the frame and press into place with the palm of your hand.

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32. How soon can I see one of these?

We currently have them in stock, but homecare dealers usually won't purchase a mask they have not examined closely, so you may need to wait until after the Medtrade tradeshow (October 29-31). We will be showing the mask to dealers there, and unless they saw it at the AARC meeting in September, then that will be their first opportunity to get a closer look.

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33. Does the headgear need to be replaced periodically?

Yes, you will need to replace your headgear occasionally. Like mask cushions, the life of headgear depends on use, the oils from your skin, and care (cleaning etc). Taking good care of your mask and headgear is the key to maintaining optimal performance and mask fit. Wash your headgear at least once per week, and dry it out of direct sunlight. If you have oily skin, you may need to wash it more often. Headgear should last longer than a cushion, but it will depend on use and environment. Speak to your home healthcare dealer about how often you are eligible for new headgear.

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34. What is the best way to adjust the headgear for a proper fit? Most home healthcare companies fit while the patient is standing. Isn't it better to fit while lying down in bed?

It is always best to adjust the mask while the patient is lying down. Facial muscles change when we lie down and further relax once we are asleep, so it is always best to fit the mask while the patient is in their sleeping position. If you sleep in a bed with no pillows, fit your mask like that. If you sleep in a recliner, fit your mask that way.

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35. Other masks have given me sores on the bridge of my nose. Will the Mirage Vista do the same?

It is much less likely for two reasons. First, the Mirage cushion technology requires very little pressure to form a seal. Second, the Mirage Vista rests lower on the nose than most masks, so it's not on the most sensitive part of the nasal bridge.

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36. Is this mask better than the Mirage or Ultra Mirage masks?

It's purely a matter of preference, but I encourage you to give it a try. It is smaller than our other Mirage masks, fits asymmetrical faces, and offers an improved field of vision, decreasing feelings of claustrophobia.

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37. If I buy a Mirage Vista from an online vendor, what size should I order? I use a standard Ultra Mirage right now.

The standard Mirage Vista should fit you. You can always call our customer service department and order a mask-fitting guide for the Mirage Vista mask. Call 1.800.424.0737.

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38. I don't have a homecare provider. Can I order a mask directly from your Web site? And do I need a doctor's prescription to do so?

ResMed does not sell directly to patients, but if you need information about where you can get a product, you may contact ResMed customer service at 800 4243 0737. We can refer you to a homecare dealer near you.

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39. You said the mask needs to be cleaned at least once a week. Do I have to disassemble it every time?

You should disassemble and clean every part at least once a week, but the Mirage Vista does not need to be taken apart every time it is cleaned. I'd recommend cleaning the cushion nightly, but it is easy to remove and reattach with the Quick Connect Cushion feature.

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