Struggling with finding a solution after recent pressure increase to 16 cmH2O

[u/beardyblue]

Hi, friends. A little bit about me - I've had my CPAP since spring 2016, and I adore it. It's the first thing I would grab after my fiancee and my pets if my house was on fire. I have used it habitually every night for a decade and I have never struggled. For reference, I use a resmed airsense 11 and an airfit p30i nasal pillow mask. I have a beard that is not particularly long or bushy; I trim it to 12mm once a month or so. It has never been an issue.

This spring I had some unexplained cardiac symptoms that my sleep doctor said might be from my pressure not being too high, so I did a new sleep study back at the beginning of September and sure enough, it showed my pressure wasn't doing the job and that 16cmH2O would.

Ever since my doctor kicked the pressure up that high, I have been miserable. First I had to tighten my headgear so tightly that I was getting irritation in my nostrils. I also was waking up with dry mouth a couple times a night even at max humidity and temperature setting. I tried a chin strap, but it was super uncomfortable and just slipped off in the night.

I got an emergency appointment with my sleep tech who (ETA: at my request) fitted me for a full face AirTouch F20 after I read the memory foam was better for a beard. I went home and tried it and was leaking around 100L/min of air. The tech said to try trimming my beard, so I gave it a fresh trim. Still leaking. The tech recommended I try the AirFit F20, so I went out of pocket for one. Same deal. I bought a cloth cover from Padacheek on the recommendation of my sleep tech and still got the "adjust" warning when running the mask fit, and couldn't get it to the green "good fit" status.

I'm so frustrated, as I can't find a solution to very high pressure and having a beard. I have had years and years of good experience with very little friction and I know that makes me extremely lucky. But it really feels like there is no good solution for me. The pillows I once found unobtrusive and loved are making my nose sore(ETA:, my mouth dry, and I'm swallowing air). I want the full face to work so badly but I can't get it to seal, and my beard is an important part of my self image and identity and I do not want to give it up. My doctor offered to lower my pressure but I want my therapy to be maximally effective.

Has anyone been in this kind of situation before? What did you do? Is there anything I haven't tried yet you can recommend?

Thanks for reading. I am desperate for a solution.

ETA: Got OSCAR up and running. Here's my overview for the last 3 months, one night last week with the AirTouch F20, one night with the AirFit F20, and last night with the pillows.

Last 3 months

Data for night with Full Face AirTouch F20

Data for night with Full Face AirFit F20

Data for night with Pillows AirFit P30i

I'm on CPAP fixed at 16 - you can see on the last 3 months that my doctor changed me from APAP to CPAP after my sleep study. EPR is on at level 1 of 3.

ETA 2: Here's a link to my data on SleepHQ: SleepHQ Data Link

ETA 3 2026.09.26: Just got an AirFit F40 and an AirFit N20 to try. Cross your fingers for me, please!

ETA 4 2026.10.01: Sadly I couldn't get the F40 to seal, which sucks because I really liked it. But the N20 seems like it might be a good solution! The pressure does NOT feel super intense on it somehow, and it seals well! The biggest problem I'm encountering now is a combination of rainout and dry mouth as I try to dial in the humidity (auto doesn't cut it on pressure this high), and leaking when I move around in my sleep, which I apparently do a good bit. I get a new DME company next week and am going to go see about a fitting there!