Air Quattro vs F20

Hi, I'm on BiPAP with a pressure of 23/19.
I currently use a Resmed F10 XS but have to have it so tight I have a dent in the back of my head and I get headaches cause it's so tight. I also had permanet red marks around my mouth and nose.

I have recently tried the Resmed F30i S, I was surprised that it did not leak much, it was comfortable but the holes under my nose were not in the right position, no matter what I tried, causing one of my nostrils to be completely blocked.

Last night I tried the Resmed Vitera S S. but it was too big and kept leaking in my eyes plus it was low and the exhaust blew strongly right across the bed, most of my other masks did not release the air that far. If they had an XS I think that would have been better.

I'm tossing up between the Resmed F20 which has good reviews but does not come in XS and the Resmed Quattro which comes in XS BUT I think I will have the same problems with the exhaust being hard and noisy.

Please Help.

Your pressure is on the high side. The full face masks you mentioned all have relatively big cushions which results in the air pressure pushing the cushion off of your face with a lot of force so your headgear has to work really hard to hold the mask on (resulting in the dent on the back of your head). I wouldn't recommend you try the F20 because I've seen photos of the bottom of the headgear cutting into the base of the neck on some people when the pressure is high like yours. Under-the-nose full face masks like the DreamWear Full Face, F30i, F30, and Amara View are smaller so the pressure can't push the mask off your face as hard. If the F30i didn't work for you, the DreamWear Full Face has a similar design but the opening for your nose is more open so it might solve your problem. The Amara View also has a bigger opening and has the hose in the front if you prefer that style.

My wife and I both use the F20 mask. My pressure starts at 19 and sometimes goes over 20. My wife's pressure often goes over 20 and we have had no problem using these masks.