Pediatric Continuous Positive Airway Pressure (CPAP)
When it comes to treating obstructive sleep apnea (OSA) in children, surgery to remove the tonsils and adenoids is the most common treatment.
For children who still have OSA after surgery, or for children for whom surgery is not a good option, treatment with a continuous positive airway pressure (CPAP) may be recommended. A CPAP machine delivers condensed air to the patient via a mask that fits over the nose and sometimes also over the mouth.
If surgery does not relieve your child’s sleep apnea, or if surgery is not indicated, CPAP can be helpful. CPAP may also be prescribed for children with OSA before they undergo surgery.
CPAP is a machine that gently blows pressurized air through a child’s nose at a pressure high enough to keep his/her throat and airway open. The pressure setting is adjusted according to the child’s needs, and should be tested and monitored by your child’s doctor or sleep specialist.
CPAP may be necessary because if OSA is left untreated over time, it can have negative health effects – placing strain on the heart and impairing your child’s cognitive development.
What to Expect
Many children do not accept or adapt to wearing the CPAP mask and air pressure right off the bat. It is quite common to require some help adjusting to the treatment.
If your child resists the mask, do not force it – if he or she feels scared or traumatized, it can make it more difficult to get him or her to accept CPAP in the long run. Discuss the situation with your doctor, who can help your child through a process of getting used to CPAP, which we call desensitization.
Your child’s doctor and care team can provide recommendations on how to practice with your child at home to help him or her get used to the CPAP mask and machine.
How effective is CPAP?
CPAP is extremely effective – almost 100% effective – in treating sleep apnea. However, in most cases of OSA in children, CPAP is recommended only if surgery (most often adenotonsillectomy) is ineffective at relieving the sleep apnea, or if surgery is not an option. Sometimes CPAP may be recommended while a child is waiting to undergo surgery.
What techniques will help my child adjust to CPAP?
Many children have difficulty accepting CPAP, and our team of experts is here to help your child learn to use the necessary treatment. If a child has difficulty accepting CPAP, we recommend he or she first practices with the device during the day, instead of immediately expecting him/her to be able to fall asleep with the mask on.
You can pair the CPAP practice with an enjoyable activity, such as turning on your child’s favorite movie or TV show, so he or she learns to associate CPAP use with something positive.
Show your child photos of different people wearing masks, like astronauts, firefighters, or scuba divers, so he or she learns that masks are “cool” and not scary. Your child should first be allowed to touch and hold the mask in his/her hand to learn it is not painful or scary, before trying to put it up to his/her face.
Once he or she is able to place the mask gently up to the face without fear or crying, we then begin to put the straps and headgear on, which secures the mask on the face. Once the child is able to wear the mask and headgear, we introduce the air pressure as the last step in the desensitization process.
Children should be taught that only adults are allowed to remove the mask, and parents/caregivers should remove the mask only while the child is calm. If the mask is removed while the child is crying or fighting, this reinforces the negative behavior because the child learns that this behavior will result in their desired outcome (removing the mask). With the right practice at home, most children can eventually learn to successfully use their CPAP.
Will my child need to use these treatments for the rest of his or her life?
As long as your child is still growing, your child’s face and airway are also still growing and changing. Sleep apnea frequently improves over time as your child’s airway naturally gets bigger as he or she grows. However, it is always difficult to predict what the future may hold, and your sleep specialist may be able to provide a more individualized answer to this question depending on your child’s specific anatomy and medical diagnosis.
- Children’s Health -- Sleep-Disordered Breathing & Sleep Apnea
- American Sleep Apnea Association – Children’s Sleep Apnea
- WebMD – Treating Sleep Apnea in Kids Improves Behavior, Quality of Life