Moderated Chat Transcript: The ResMed Mirage Family of Masks

With ResMed's Karla Tate and Susie Justus, LVN

Karla Tate has been a Product Manager with ResMed for the last 5 years. She currently manages all of ResMed's masks and accessories for the Americas. Her educational background includes a Bachelor's degree in Industrial Design and a Master's in Business Marketing.

Susie Justus, LVN, has 25 years nursing experience and is a Clinical Specialist at ResMed. Prior to joining ResMed in 2000, she spent 4 years as manager of a very successful ENT/out-patient sleep medicine department.

Questions

1. Why should I and how often should I replace my mask cushion?
2. Does headgear need to be replaced?
3. 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?
4. If the mask is strapped on so tight (to get a seal) that it is painful, does this indicate the wrong size mask?
5. What are the preferred cleaning instructions for the Ultra Mirage . . . how often should we clean and with what cleaning solution?
6. Sore spots on the nose bridge or face caused from the headgear (straps) of the Ultra Mirage mask . . . if an ointment like Neosporin or Vaseline is used, will this harm the mask? If Vicks Vaporub is routinely used on the upper ip to keep nasal passages open due to colds or allergies, will this harm the mask or cause it to wear out quicker?
7. What is the life span of your masks and flow generators?
8. Can the mask be used for all pressures?
9. I have been happily using a standard Mirage mask for 3 years. Why should I move to the Ultra Mirage mask?
10. I am using the AutoSet T™ which is the best! But I am testing an IQ mask for Sleep Net corp.; is it okay to set the software for "Mirage," which looks to be the same size and type mask?
11. I am using the Ultra Mirage setting for my non-ResMed mask and it seems to be working fine; any concerns?
12. How can I keep the gel part on the frame of the mask? It keeps coming off. I have an Ultra Mirage.
13. Who needs the Ultra Mirage mask instead of the Mirage mask?
14. Can the ResMed mask family be used with just about any other brand of CPAP?
15. Concerning the Ultra Mirage: is there any way to obtain one of those tiny little clasps?
16. Can the mask cap or straps be purchased separately?
17. What do you mean by one-touch forehead adjustment?
18. Is there a way to tell which mask you have? I am new to this?
19. When did the Ultra Mirage come on the market
20. I have been having problems keeping my mask on at night - I often wake up to find out that I've removed it in my sleep. Any suggestions? It's usually more prevalent when my allergies and sinuses are acting up.
21. My Ultra Mirage works for me, I have a fairly large nose. Do they work for all people? How many sizes are there?
22. Concerning the Ultra Mirage mask: with the air entering and exiting via the same orifice, how can one tell if there is the correct pressure inside the mask? It certainly feels as if it's a lower pressure than my Mirage FF mask?
23. I wash my cushion with mild hand soap and warm water. Is this acceptable or should something else be used?
24. Does ResMed see a trend toward the full face type mask?
25. Is there a different headgear available for the Ultra Mirage mask? I had one for testing and found that it did not fit my head very well.
26. I have had problems with masks and pillows breaking my face out like acne pimples, why does this do that?
27. How do DME techs get trained so that they can properly fit the Mirage or Ultra Mirage masks?
28. What do you do about leaks, especially around the nose area?
29. If I buy an Ultra Mirage from an online vendor, what size should I order? I used a medium Gold Seal for my sleep study.
30. Is the Ultra Mirage mask easy to break?
31. If I snore a lot, will the full-face be better for me than the Mirage mask?
32. What patient group are the Mirage masks made for?
33. How does the Respironics mask stack up against the Mirage mask?
34. How long should the Ultra Mirage mask last under normal wear and cleaning?
35. Can we order masks directly from your website? And do we need a doctor's prescription to do so?
36. What does a leaking Ultra Mirage mask indicate?
37. I'm a mouth breather and wanted to try the full-face mask, but really like the Breeze. I was using the Breeze and taping my mouth shut, but one doctor was worried about the possibility of aspiration. I felt that the Ultra Mirage mask was too confining, and limited my nasal breathing somewhat. What would you recommend?
38. How can you tell what size mask you have?
39. Suppose the power goes out? Would that be a reason not to go with the full face mask unless there were other factors, such as allergies, etc.
40. Should you take the Ultra Mirage mask apart to clean it or just wash it all in one piece?
41. Can the shallow cushion be bought separately?
42. Can I purchase a shallow cushion on ResMed.com and will it fit directly into the mask I am using now or do I need a new mask?
43. What are the straps on the Mirage made of? How should they be maintained?
44. How about secret tips for a new user? Got my CPAP today!!!
45. I am at a pressure of 8 and was told that is was not enough pressure to use the Mirage mask. Is this true?
46. I tried an Ultra Mirage standard, it kept leaking air around the nose. I contacted my rep who didn't tell me about the different sizes, so you are saying that I could possibly need a different size?
47. Do you recommend cleaning with distilled vinegar with the masks?
48. How do I choose the best mask?
49. Are there any more breathable materials coming available for the straps to help prevent acne from forming under them?
50. Have been on the CPAP for about a month. I really don't find any physical difference. Any suggestions?
51. How can you make sure that the DME Company delivers the machine and mask you want?
52. If I purchased the shallow cushion, do I have to order another mask or will it fit into the one I have now.
53. Can the Ultra Mirage be worn with glasses?
54. Is the Mirage suitable for use with a moustache?
55. I have an exceptionally large nose; I am now using a standard (Ultra Mirage mask) size, fine except for my bridge, should I consider a large mask?
56. This is the first I've learned that there are different sized cushions. Would the cushion size impact how much compression I felt on the sides of my nose from the Ultra Mirage mask? Are there different cushion sizes for the full-face mask?

Answers

1. Why should I and how often should I replace my mask cushion?

You should replace your mask cushion periodically because as it becomes worn, it becomes less effective. The life of a mask cushion depends on use, the oils from your skin, and care (cleaning etc), so there's no standard replacement schedule. It is always a good idea to inspect your mask routinely; poor care may adversely affect the fit of the cushion, and thus performance. To get the longest life from your mask, be sure to wash your face each night before putting on your mask, and wash your mask after each use. Use only pure soap, nothing with perfumes, moisturizers, antibacterial agents, bleaches, etc, and always dry your mask and cushion out of direct sunlight.

Poor performance is often the first clue that your cushion may need replacement. Check for small tears or pinholes, anything that might cause a leak. Cats have been known to damage cushions by playing with them, and so have children, so you may want to keep your mask out of reach. You may also want to look at the spot where you leave your mask. Some people leave their masks on their nightstands. If you have a halogen reading light, you may want to store it somewhere else. A halogen light produces a lot of heat, and if it's too close to your mask, it could cause heat damage. Also, be sure you don't leave your mask somewhere that receives direct sunlight during the day.

 

2. Does headgear need to be replaced?

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 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 your insurance will pay for new headgear.

 

3. 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.

 

4. If the mask is strapped on so tight (to get a seal) that it is painful, does this indicate the wrong size mask?

The first thing it may indicate is an incorrectly fit mask. When using a ResMed mask it is important not to over-tighten the mask system. If you can only get a good seal by tightening the headgear, you probably have the wrong size cushion or an incorrectly adjusted forehead support.

If you need to over-tighten the headgear to get a seal with an Ultra Mirage mask, then try these suggestions to solve the problem: First, use the forehead support to adjust the angle of the mask relative to the face. For example, if your mask leaks into your eyes, adjust the forehead section to bring the cushion in closer contact with the nasal bridge. If this does not correct the leak or if this places pressure on the bridge of the nose, then you might need a shallow cushion. With the Mirage® and Ultra Mirage mask systems, there is a shallow cushion size, which has more membrane at the bridge of the nose. This allows a quality seal for patients with a moustache, patients who take dentures out at night, and patients with either a high nasal bridge or a low nasal bridge. We also have a large cushion size for large noses.

 

5. What are the preferred cleaning instructions for the Ultra Mirage . . . how often should we clean and with what cleaning solution?

As with any mask system it is important to wash the mask system regularly so as to optimize its life. It is also important to wash the mask correctly, which involves the following:

Hand wash mask and all components at least once a week-or more often if you have an oily skin type.

Wash in cold to lukewarm water.

Use pure soap and ensure that you use enough to remove the facial oils (approx.1-2 teaspoons in a bathroom sink and rinse well to remove residue); do not use soaps with antibacterial, moisturizing, or scent additives, and do not use products containing bleach; we recommend Ivory dishwashing liquid (non scented), Neutrogena liquid soap, and Jergens or Planet dishwashing liquid.

Dry mask out of direct sunlight.

 

6. Sore spots on the nose bridge or face caused from the headgear (straps) of the Ultra Mirage mask . . . if an ointment like Neosporin or Vaseline is used, will this harm the mask? If Vicks Vaporub is routinely used on the upper lip to keep nasal passages open due to colds or allergies, will this harm the mask or cause it to wear out quicker?

Sore spots at the nasal bridge may indicate over-tightening of the headgear or incorrect adjustment of the forehead support. You may want to consult with your DME.

If the sore spots follow the headgear path, then think about the last time the headgear was washed.

What are you using to wash the headgear? Check that your skin is not sensitive to the soap you use to wash the headgear. A pure soap such as Ivory or Neutrogena is recommended.

It is possible that you may be sensitive to the headgear material. It is made of loop stretch neoprene and nylon jersey. Neoprene is commonly used in knee braces and elbow braces.

If you use Neosporin or Vicks, this can decrease the life of the headgear. Lotions, ointments, and perfumes can all deteriorate the material over time.

 

7. What is the life span of your masks and flow generators?

The life of the mask depends on how often the mask is washed and how well one takes care of it. It is worth checking with your homecare provider about their replacement schedule; you will find that many of the mask parts can be replaced. As for our flow generators, it's hard to say. I know a lot of our early CPAPs are still working very well, but collecting accurate and complete data is difficult because people probably replace flow generators before they wear out. You may want to ask several DMEs this question and listen to what their experiences have been.

 

8. Can the mask be used for all pressures?

The Ultra Mirage mask can be used for pressures from 2 to 25 cm H2O.

 

9. I have been happily using a standard Mirage mask for 3 years. Why should I move to the Ultra Mirage mask?

The Ultra Mirage mask is a quieter mask, and it has a number of features that you might find beneficial. The cushion design is the same as the Mirage mask, but the Ultra Mirage mask has a clip that secures the cushion to the mask. The Ultra Mirage mask also has headgear clips that allow easy removal. The air tubing is connected to the front of the mask via a rotating elbow, which allows free movement of the tubing. The Ultra Mirage mask also has one-touch forehead adjustment.

 

10. I am using the AutoSet T™ which is the best! But I am testing an IQ mask for Sleep Net corp.; is it okay to set the software for "Mirage," which looks to be the same size and type mask?

We tested the IQ mask in July 1999, and we found it ineffective with any of the AutoSet T settings. Even when masks look the same, they can have very different flow characteristics, which the AutoSet T must know for accurate autotitration. The known flow characteristics of ResMed masks are used by the AutoSet T to calculate the pressure it needs to send out.

 

11. I am using the Ultra Mirage setting for my non-ResMed mask and it seems to be working fine; any concerns?

It will depend on what type of mask you are using. If the flow characteristics of the mask are different than the Ultra Mirage mask, then it could be a problem.

 

12. How can I keep the gel part on the frame of the mask? It keeps coming off. I have an Ultra Mirage.

If you are referring to the cushion, then you should have your cushion clip checked, as it should not come off the frame.

 

13. Who needs the Ultra Mirage mask instead of the Mirage mask?

Both masks are designed for the same patient group, so the choice is really a matter of preference. Take a look at an Ultra Mirage mask and decide for yourself. www.resmed.com

 

14. Can the ResMed mask family be used with just about any other brand of CPAP?

It should be fine, but if you're using a non-ResMed autotitrating PAP device, you may want to check with that manufacturer.

 

15. Concerning the Ultra Mirage: is there any way to obtain one of those tiny little clasps?

This part is available separately from your DME. Give them a call, and they should be able to get one for you.

 

16. Can the mask cap or straps be purchased separately?

All mask parts can be purchased separately through your DME. Part numbers (codes used to order) for each part are available on the ResMed web site. www.resmed.com/us/1003964745277.html

 

17. What do you mean by one-touch forehead adjustment?

The forehead section has a button you can push to adjust the forehead section. There is a demonstration of this on our web site. Select the button called "Watch it Work" on the Ultra Mirage mask product page. www.resmed.com/us/1003964750985.html

 

18. Is there a way to tell which mask you have? I am new to this?

If it is ResMed Mirage mask, the tubing can only go over the head. If it is the ResMed Ultra Mirage mask, the tubing can rotate 360 degrees-it is also marked on the forehead section. Again, you can check our web site at www.resmed.com

 

19. When did the Ultra Mirage come on the market?

I believe the Ultra Mirage mask was released in March 2000.

 

20. I have been having problems keeping my mask on at night - I often wake up to find out that I've removed it in my sleep. Any suggestions? It's usually more prevalent when my allergies and sinuses are acting up.

This type of problem is likely occurring due to nasal congestion. With a history of sinus and allergy problems you may be better treated with a full face mask and/or humidification. You should discuss this with your primary care physician.

 

21. My Ultra Mirage works for me, I have a fairly large nose. Do they work for all people? How many sizes are there?

The Ultra Mirage mask has been very successful with the majority of the population. There are 3 sizes of mask: standard, large, and shallow.

 

22. Concerning the Ultra Mirage mask: with the air entering and exiting via the same orifice, how can one tell if there is the correct pressure inside the mask? It certainly feels as if it's a lower pressure than my Mirage FF mask?

The air actually enters through air hose and exits through the exhalation port (located on the elbow).

 

23. I wash my cushion with mild hand soap and warm water. Is this acceptable or should something else be used?

As with any mask system it is important to wash the mask system regularly so as to optimize its life. It is also important to wash the mask correctly, which involves the following: hand wash mask and all components at least once a week (more often if you have an oily skin type) in cold to lukewarm water; use pure soap and ensure that you use enough to remove the facial oils (approx.1-2 teaspoons in a bathroom sink and rinse well to remove residue); do not use soaps with antibacterial, moisturizing, or scent additives, and do not use products containing bleach [we recommend Ivory dishwashing liquid (unscented), Neutrogena liquid soap, and Jergens or Planet dishwashing liquid]; dry mask out of direct sunlight.

 

24. Does ResMed see a trend toward the full face type mask?

Recent studies have shown the importance of solving mouth leak for sleep quality. As this becomes more widely recognized, ResMed anticipates that the number of people fitted with these masks will grow.

 

25. Is there a different headgear available for the Ultra Mirage mask? I had one for testing and found that it did not fit my head very well.

There is an alternative headgear available which is a stretch Velcro (product code 16101).

 

26. I have had problems with masks and pillows breaking my face out like acne pimples, why does this do that?

There are several possible reasons your face may be breaking out:

If your skin type is oily, then it is important that you wash your face prior to using the mask each night. The acne could be due to the oils on the face and the mask not allowing the skin to breathe. It's also best not to wear moisturizers under the mask system.

Although this is unusual, it is possible that you may be allergic to the silicon. The majority of the masks on the market are made of silicon, so hopefully this is not the problem.

The other possibility if you have changed face soaps recently is that you may be allergic to it. You might want to try with another type of soap.

 

27. How do DME techs get trained so that they can properly fit the Mirage or Ultra Mirage masks?

ResMed has an educational program section, which offers continuing education courses, covering areas such as mask fitting.

 

28. What do you do about leaks, especially around the nose area?

First, use the forehead support to adjust the angle of the mask relative to the face. For example, for leaks into the eyes, adjust the forehead section to bring it in closer contact with the nasal bridge. If this does not correct the leak or if this places pressure on the bridge of the nose, you might need a shallow cushion. With the Mirage and Ultra Mirage mask systems, there is a shallow cushion size, which has more membrane at the bridge of the nose. This allows a quality seal for patients with moustaches, patients who take dentures out at night, and patients with a high nasal bridge or a low nasal bridge.

 

29. If I buy an Ultra Mirage from an online vendor, what size should I order? I used a medium Gold Seal for my sleep study.

I'm not sure how the Gold Seal sizes work, but our standard cushion fits the majority of patients. You can always call our customer service department and order a mask fitting guide for the Ultra Mirage mask. Call 1.800.424.0737.

 

30. Is the Ultra Mirage mask easy to break?

No, it's a very sturdy mask. If it's abused, it's more likely to come apart than break, in which case you will need to reassemble it.

 

31. If I snore a lot, will the full-face be better for me than the Mirage mask?

Hopefully you mean snoring a lot without using CPAP. If you are snoring with the mask, you may need to look at your treatment pressures. Anatomy plays a great part with patients who snore and this may be more of a physical problem, in which case a full face may be better, but you should discuss this option with your physician.

 

32. What patient group are the Mirage masks made for?

The Mirage masks are made for patients with sleep-disordered breathing on CPAP or bilevel.

 

33. How does the Respironics mask stack up against the Mirage mask?

Keep in mind that mask preferences are very individual, and you should test all your options and choose the one that best meets your comfort and treatment needs. ResMed's Mirage and Ultra Mirage masks have a large portion of the mask market, so they have passed this test for many people, but do your own research and make your own decision. You may or may not be happy with what most others like.

 

34. How long should the Ultra Mirage mask last under normal wear and cleaning?

There is no hard and fast rule. The life of the mask depends on how often the mask is washed and how well one takes care of it. It is worth checking with your homecare provider as to the replacement schedule as you will find that many of the mask parts can be replaced.

 

35. Can we order masks directly from your website? And do we 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 product you may contact ResMed customer service at 800 4243 0737.

 

36. What does a leaking Ultra Mirage mask indicate?

This may indicate one of several things.

• The mask may be incorrectly adjusted
• The mask may be incorrectly assembled
• The mask may be the incorrect size.

My first suggestion is to double-check the cushion clip to make sure it is secure. When it's not properly attached, leak can occur. My second suggestion is to check the fit-how it is adjusted. It's important that your Ultra Mirage not be over-tightened. Over-tightening not only causes discomfort, it may stop the mask's ability to seal. If you're not sure that the mask is adjusted correctly, it's a good idea to speak with your home healthcare provider. Your home healthcare provider will also be able to check that you have the correct size cushion. My third suggestion is a question. How has the mask system been maintained? As with any mask system, frequent care increases life span (wash at least once per week). It is also important to wash the mask correctly (see previous mask cleaning instructions).

 

37. I'm a mouth breather and wanted to try the full-face mask, but really like the Breeze. I was using the Breeze and taping my mouth shut, but one doctor was worried about the possibility of aspiration. I felt that the Ultra Mirage mask was too confining, and limited my nasal breathing somewhat. What would you recommend?

As your doctor has said, taping your mouth can be dangerous. If you are experiencing mouth leaks, a chinstrap or a full-face mask are really the best options.

 

38. How can you tell what size mask you have?

The size is "written" on the sidewall of the cushion.

 

39. Suppose the power goes out? Would that be a reason not to go with the full face mask unless there were other factors, such as allergies, etc.

The ResMed Mirage full face mask has safety features built into the mask which will allow you to breathe room air in the event of a power failure. There is also an emergency quick release, which allows the mask to fall away from the face when pulled. These can be seen on the ResMed web site www.resmed.com

 

40. Should you take the Ultra Mirage mask apart to clean it or just wash it all in one piece?

The Ultra Mirage does not need to be pulled to pieces every time it is cleaned. Ideally the cushion and vent cover would be removed to ensure there is no build up of facial oils.

 

41. Can the shallow cushion be bought separately?

The shallow cushion, as with all ResMed mask parts, is available separately.

 

42. Can I purchase a shallow cushion on ResMed.com and will it fit directly into the mask I am using now or do I need a new mask?

ResMed does not sell directly to patients; you will need to talk to your DME. However, if your DME does not sell parts, you may contact ResMed customer service to find a dealer in your area that does. Yes, all three size cushions will fit on the same frame.

 

43. What are the straps on the Mirage made of? How should they be maintained?

The are made of neoprene and nylon jersey. They should be washed at least once per week in pure soap with cold or lukewarm water.

 

44. How about secret tips for a new user? Got my CPAP today!!!

It will take time to get used to your CPAP system and mask. Be patient. Don't be discouraged if you can only use it for a couple of hours tonight. Hopefully tomorrow night you will use it a little longer and go on from there. Make the most of the support you can get from fellow users; this site has a wealth of information. Your DME will also support you. Above all don't give up, and don't feel shy about asking for help. Sleep well!

 

45. I am at a pressure of 8 and was told that is was not enough pressure to use the Mirage mask. Is this true?

No. The Mirage may be used on pressures as low as 4 cm H2O and as high as 25 cm H2O.

 

46. I tried an Ultra Mirage standard, it kept leaking air around the nose. I contacted my rep who didn't tell me about the different sizes, so you are saying that I could possibly need a different size?

If you have adjusted the forehead section (by pressing the button down and moving down one position) and continue to get leaks then a shallow cushion may be a good option for you.

 

47. Do you recommend cleaning with distilled vinegar with the masks?

I would not recommend cleaning with vinegar.

 

48. How do I choose the best mask?

It is important to pick a mask that is comfortable and does not place pressure on the sensitive areas of the face, the nasal bridge and upper lip. I suggest you try on as many as you can, talk to other users, and look at web sites. Ours is www.resmed.com : )

 

49. Are there any more breathable materials coming available for the straps to help prevent acne from forming under them?

ResMed has started using a new material called Breath-O-Prene. It pulls moisture away from the skin and allows air to circulate.

 

50. Have been on the CPAP for about a month. I really don't find any physical difference. Any suggestions?

Although you may not notice a difference, it is likely that there has been an improvement, though it may have been gradual. It has taken you years to get to the stage you needed treatment, and improvement for many is gradual rather than immediate. There are also other less obvious improvements in body functions: heart, lungs, circulatory just to name a few. However, that said, make sure that leak is not occurring (either mask or mouth leak) as these may affect your treatment and reduce the benefits of therapy.

 

51. How can you make sure that the DME Company delivers the machine and mask you want?

You need to make sure that the physician specifies the machine and mask on your prescription.

 

52. If I purchased the shallow cushion, do I have to order another mask or will it fit into the one I have now.

There is only one mask frame size for all three cushion sizes, so you won't need to purchase another one.

 

53. Can the Ultra Mirage be worn with glasses?

There is one manufacturer that sells glasses frames that will fit the Mirage and Ultra Mirage mask systems. More information is available at www.visionmed.com.au

 

54. Is the Mirage suitable for use with a moustache?

The Mirage and Ultra Mirage asks have a very thin membrane, which will typically seal even with a moustache. The shallow cushion in particular is ideal for patients with a moustache, as they may need to adjust the cushion in closer to the top lip. The shallow cushion allows the user to angle the cushion more and maintain the seal at the bridge of the nose.

 

55. I have an exceptionally large nose; I am now using a standard (Ultra Mirage mask) size, fine except for my bridge, should I consider a large mask?

A large cushion may be better for you. You may want to look at getting a template to see if it is a better fit. If you are getting pressure on the bridge of the nose, double check you have adjusted the forehead section correctly. Check our website for further information www.resmed.com

 

56. This is the first I've learned that there are different sized cushions. Would the cushion size impact how much compression I felt on the sides of my nose from the Ultra Mirage mask? Are there different cushion sizes for the full-face mask?

It is possible that a cushion that is too small may place pressure on the sides of the nose. You might be best to look at a large cushion. You can discuss this with your DME. The Mirage full face mask also comes in a range of sizes.