I wear a P10 and my head size is 61cm ~ 24inches.
I split the headgear straps completely. One of them goes just under the occipital protuberance (the bump at the back of the head). The other end is pushed all the way front about half an inch away from forehead hairline.
The straps from the pillows go up and rest in the ear creases.
When I wear it like this, the nasal pillows are loose in the nose. They are not snug at all. Then, when I start the machine, the pressure inflates the pillows a bit and they get snug fit.
My 95% leak rate is 1Lpm or less every night. I have been on the same mask and pillows for 170 days now.
I recommend that you wear it loose by following similar steps and evaluate if it is loose enough for you.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
Or forget that mask and try another. Like the Nuance. Or the Pilaro.
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Breathe deeply and count to zen.
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I agree, the P10 is too tight new. But I find it stretches out pretty fast. Shame, it is the perfect mask for me if it only had adjustable straps.
I have used this mask for more than a year and agree that the minimalist nature and light weight are ideal. Also, the nasal pillows are durable and I have used the same set for more than a year. I get very good therapy with this mask, unmodified, and like it best of the various nasal pillows masks I've tried since I started treatment in 2009.
If the headgear is too small for your head but if the nasal pillows, etc. otherwise fit, one suggestion, if you are a little handy, might be to cut the straps and use velcro to lengthen the straps to make them fit your head. I haven't done anything to modify the headgear, but for me, it is a little loose and I might try some velcro to tighten up the straps.
I Believe AshSH has a great answer.
Since I have not made 8 posts, I can not put the link to the P10 user manual. But you can go to Resmed dot Com and get it there...
Some good pictures (#3 shows a really loose fit). The more you spread the top of the head strap, the looser it will fit.
Like AshSH, I wear an XL (7 7/8") cap/hat. The P10 fits just great.
Hope the manual helps.