Years ago, we addressed this by using Adams circuit nasal prongs. It would leave my nares sore in the morning and over time I developed the habit of mouth breathing once I was sound asleep. So I switched to a full face mask. For the last couple of years I used a Resmed F20i mask, which solved many problems but position had to be absolutely perfect or I felt like I couldn't breath out of my right nare. I was using the MyAir app and typically scored 97-100, gaining full credit for a perfect seal. I will mention I have a short beard and mustache, typically between 1/4 and 1/2 inch long.
Last week I switched to the Resmed F20 which is physically bigger than the other mask and solved any problems with the mask pressing against the side of my nose, Great! But then I noted I was getting gigged by the MyAir software for having a poor seal. No more perfect scores.
Initially, I felt I was being starved for air a little so I bumped up my pressure from 10cm to 12cm. That took care of any sense of starvation. It also took me down from 1-3 events per hour to essentially 0-1.
So the question becomes, aside from the personal goal of maxing out my score every night, does it really matter if my mask leaks, given what it has done to reduce my apnea?
I have played with the straps quite a bit but can't seem to find the sweet spot. My Resmed Airsense 10 Autoset tells me I have a good seal when I use its "check fit" function but then in the morning I find I got gigged again by MyAir. Perhaps I should just adjust my expectations and be happy my AHI is so low now. God knows the mask is more comfortable than the old one. I really can't feel a leak.
Opinions?