Best mask for high pressure

[Julia63]

I am using rested air sense 10.
I'm trying to find a mask that is good for high pressure because in the middle of the night when I'm asleep I have a need for high pressure which causes a big leak and feels like a blast to my face and wakes me up enough that I take off the mask. I think if I had a better mask for high pressure then I could get adjusted to keeping it on and not having leaks. I'm hoping my doctor will be able to approve one for instance but I wanted some opinions on which ones work best. I have a small face and wear full face mask. Right now I am using F20 but I'm looking for a better mask for my situation.

[Gideon]

I use ResMed P10s every night up to 17/18 and have used them up to 25.

Post a daily screenshot and let us see is your high pressures are needed or if it is something we can correct.

[clownbell]

I'm not in Gideon's league, but just as a plain user I think the P10 is the best mask I have ever used. FWIW, I have used about a dozen different masks -- full face, nasal, and pillows. Please do not discount Gideon's input.

[kakadyi]

I use ResMed P10s every night up to 17/18 and have used them up to 25.

Post a daily screenshot and let us see is your high pressures are needed or if it is something we can correct.

Sorry for not my post intruding, but P10 will work when one nostril is obstruct due to inferior turbinate swelling?

[pholynyk]

We often breathe with one nostril obstructed - at least, I do.

The P10 or Brevida will work better than a nasal or full face mask because it allows the outside of the unobstructed side to expand out - all the CPAP pressure is on the inside.

[ragtopcircus]

I use an F30i with BiPAP 14/20 (fixed, PS 6).

Expanding on @pholynyk's point, masks that provide a pressure differential between the inside and outside of the nose will act kind of like a Breathe-Rite strip. This includes pillow masks such as the P10 or P30i, under-nose masks such as the original Dreamwear or N20i, and hybrid masks such as the F30 or F30i.

I like the F30i because it makes it easier to breathe through my nose. It helps keep the nose open, and by avoiding a pressure differential inside vs outside the lips, makes it easier to keep the mouth closed.

However, getting the straps adjusted right on the F30i is a bit more finicky. Your upper jaw acts like a fulcrum, so overtightening the upper straps can cause leaks below the upper jaw and vice-versa. The adjustments are interactive, so it does take a bit of dialing in.

For any mask that has straps at the back of the head (instead of just at the crown like the P10), moving your head up and down can signficantly change the mask fit. Place your hand on the back of your head where the neck muscles attach and nod - you'll feel why. Foam neck collars help stabilize the fit, and also help prevent chin tuck that can collapse the airway. I've recently started experimenting with just tilting my head down a bit as I adjust the straps, but that did go hand-in-hand with acclimating to higher pressure.

[ragtopcircus]

Btw, the mask's tug on the straps is proportional to both the pressure and the frontal area of the mask. The frontal area of the F20 is relatively large. It's a very popular mask and obviousy works well for some. However, I don't use an F20 anymore because I couldn't stop the leaks, and because it doesn't have that nose-expanding effect.

[multicast]

One way to get a better seal with the F20 at higher pressure is to insert a thin and soft silicon-hose, please look carefully at the attached picture.  Here a 6mm diameter is used.  Works well with pressures of 20 and beyond.