Pediatric continuous positive airway pressure (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.

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 your child 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.

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.