Mirage Activa LT Design Improvements - A Comparison of the Mirage Activa LT and the Mirage Activa
By Andrew Senske, President CPAP-Supply.com
Last Updated 1/15/2009 12:38:00 PM

Mike here at CPAP-Supply.com has been using the ResMed Mirage Activa since it was first released several years ago. He loves the Mirage Activa, and recommends it to just about anyone who needs a nasal CPAP mask. So it was with a bit of skepticism that he tried the Mirage Activa LT last night after receiving our first shipment earlier in the day. His attitude was something along the lines of "why fix it if it ain't broke". Skepticism notwithstanding, Mike tried the mask and gave me his report this morning. After analyzing the mask myself and making some notes, including the fact that the LT doesn't have a quick-release for the tubing, I was thinking the report from Mike would be luke warm at best. What I heard on the other end of the phone, though, was a guy who has traded in his old Activa for a new Activa LT.

Here are some of the first things Mike said:

"I loved it. It's more comfortable. It covers less of the nose. It has less visual impact. And quiet? It's absolutely silent! It's a better mask."

Pretty positive feedback from someone who has been using CPAP therapy for nearly 15 years, and who thought the original Mirage Activa was the bees knees. The only aspect of the mask Mike didn't like was the incorporation of the headgear clips found on the Ultra Mirage II nasal mask. The side-squeeze style of clip on the original Activa is easier for him to handle than the smaller center-press style of clip on the Activa LT.

I asked Mike if he missed the quick-release elbow that allows Activa users to make those quick middle-of-the-night trips to the bathroom or to let the dog out, without having to take the entire mask off. He said he doesn't miss this feature at all because he only used it once or twice in several years.

The first difference you'll notice between the Activa and Activa LT is the size and contents of the package. The original Activa comes in a zippered case and includes both a written user guide and a DVD. Inside the zippered case with the Activa is the Activa quick-release mask elbow connected to an 11-inch tube. The Activa LT, on the other hand, comes with a drawstring pouch and only a written user guide - no DVD or short tube with the Activa LT. The LT elbow will connect directly to your long tube that attaches to the CPAP machine, and you'll lose 12 inches of tubing length as a reult.

ResMed Mirage Activa.
Mirage Activa
ResMed Mirage Activa LT.
Activa LT

The Activa LT's more traditional elbow has a ring of 22 little exhalation holes formed right in the hard plastic of the elbow. It appears that the design of these holes will disperse air in 360-degrees perpendicular to the direction the mask is facing. This means that the air won't be blowing directly on your bed partner. ResMed says the Activa LT is about 50% quieter than the Activa. Mike tends to agree.

I've already read a complaint from a European user on a CPAP forum website about a problem with condensation building up in these little holes when a humidifier is used as part of the CPAP therapy system. The user indicated that when water droplets build up on the holes, the mask whistles. The whistling could make sense in this case. As the vent holes get smaller by being blocked or partially blocked, the air traveling through them speeds up and causes more noise. However, I would think that the water would just be blown out of the holes. Perhaps the user misunderstood where the whistling noise was coming from. I'm not really sure. Anyway, if you've got a lot of condensation in your mask, you should address that issue, and then your Activa LT mask (or any other mask, for that matter) shouldn't whistle. Without a humidifier, this will never be an issue.

Mirage Activa Air Vent.
Activa Air Vent (4 Holes in Silicone)
Mirage Activa LT Air Vent.
Activa LT Air Vent

The Activa LT features the forehead support dial found on both the Mirage Micro and Mirage Quattro. This 24-position forehead adjuster allows for fine tuning of the mask fit, and helps users get rid of any pesky leaks they may encounter when using the mask. This is in contrast to the 4-position forehead adjuster on the original Activa. The silicone forehead support pad on the Activa LT is a holdover from the Activa.

Mirage Activa Forehead Support.
Activa Forehead Support
Activa LT Forehead Support.
Activa LT Forehead Support

While the headgear strap is shared between the two masks, the headgear clips are not. The original Activa features large green clips that are released by squeezing the sides of the clip together. The new Activa LT features small blue clips that are released by pressing a button in the center of the clip. These small blue clips are the same as those found on the Ultra Mirage II nasal mask, although they're blue now instead of green. Interestingly, this is the third color this particular clip has had. It started out clear, then it was turned green, and now it's blue. It's the same part number (ResMed part number 16569), just a different color.

Mirage Activa Headgear Clips.
Activa Headgear Clip
Activa LT Headgear Clip.
Activa LT Headgear Clip

Both the original Activa and the Activa LT have unique Active Cell cushions which absorb some of the forces applied to the mask as users move around during sleep. Both Activas are designed for active sleepers. The cushions on the Activa LT are slightly smaller in overall size, but the cushions are interchangeable between the two masks. The cushion clips are identical except in color. Therefore, an Activa LT cushion and clip can be installed on an original Activa mask frame. An original Activa cushion and clip can be installed on a new Activa LT mask frame.

When comparing a standard size cushion from the original Activa to the medium size cushion from the Activa LT, the actual interface that seals against the user's face is exactly the same size. If you use a size standard in the Activa, you'd use a size medium in the Activa LT. If you use a large in the Activa, you'd use a size large in the Activa LT. There's a new sizing option, though, with the Activa LT. Rather than standard, large and shallow - the three sizes offered with the original Activa - the Activa LT offers medium, large and large-wide. After measuring the old shallow and the new large-wide I've determined the interface is essentially the same size. Remember, too, that the cushions are interchangeable between the two masks. If you've stocked up on Activa cushions, you can make the switch to the Activa LT and still use those cushions you already own.

Incidentally, the shallow Activa cushion weighs 1.6 ounces while the large-wide weighs 1.5 ounces.

Mirage Activa and Activa LT Cushion Comparison.
Activa (Left) and Activa LT (right) Cushions

The issue that will probably be a very critical one for most users is that of price. We've got great news. The Mirage Activa LT is priced well below the Mirage Activa. Because of the design improvements and the price I think the Mirage Activa LT is going to become the workhorse of the ResMed nasal mask product line. It's essentially a cross between the Mirage Micro and Mirage Activa, combining the best of each of those masks into one impressive CPAP mask.

If you absolutely must have the quick-release elbow then you should stick with the original Activa. If you can do without that, and if you want to save some money and enjoy some of the benefits of the new Mirage Activa LT, then you should make the change.

Andrew Senske

CPAP-Supply.com is a leading online retailer of CPAP equipment. Located in Spokane, WA CPAP-Supply.com has been serving thousands of customers around the world since 2001. Founded on a belief that patients are their own best primary care providers, CPAP-Supply.com understands the importance of educating patients and customers on both the effects of and treatment for obstructive sleep apnea. For more information visit CPAP-Supply.com or call toll free 1-888-955-2727.