Continuous Positive Airway Pressure (CPAP)

Key points about continuous positive airway pressure

• continuous positive airway pressure (CPAP) is a treatment for obstructive sleep apnoea (OSA)
• OSA is a medical condition - narrowed breathing passages make breathing more difficult during sleep
• a CPAP machine takes normal air from the room and blows the air into your child's breathing passages through a mask
• CPAP makes it easier to breathe and is a safe and effective treatment for OSA
• it's best for your child to use CPAP every night for the greatest benefit
• it can take time for your child to get used to this treatment - the child health team caring for your child will help with this
• regular check-ups are important to make sure the mask is fitting well and the CPAP pressure is set correctly

Treating obstructive sleep apnoea leads to better quality sleep and can lead to improved daytime behaviour and concentration.

What is continuous positive airway pressure?

Continuous positive airway pressure (CPAP) is a treatment for obstructive sleep apnoea (OSA). In OSA, the upper breathing passages become narrowed and more floppy during sleep.

Read about snoring or noisy breathing

A CPAP machine blows air into the breathing passages

A CPAP machine holds the breathing passages open by blowing air from the machine through a tube connected to a mask. From the mask, the air goes into the breathing passages (nose and throat). The air blows at a set pressure to stop the breathing passages from narrowing as happens in OSA. CPAP helps your child to breathe more easily and to have a more restful sleep.

Masks come in different shapes and sizes

Masks come in different shapes and sizes - they may just cover the nose, or both the nose and mouth. A small cap and straps hold the mask in place. A member of the child health team caring for your child will make sure that the mask fits comfortably. They will set up the machine so that it's right for your child. They will also teach you how to fit the mask and manage the machine at home.

Watch videos of babies sleeping with CPAP machines

KidsHealth video

KidsHealth videos

CPAP machine helping sleeping baby to breathe more easily

Baby sleeping with CPAP machine - close up

Benefits of CPAP for children

CPAP is a safe and effective treatment for children with OSA.

Below are some benefits children can have once they begin using CPAP.

Feeling better

Children with severe sleep apnoea symptoms generally feel much better once they begin using CPAP. You might notice that your child is easier to get up and going in the morning. 

Sleeping better

Your child should sleep better after using CPAP. You might notice that their breathing is easier with less effort and their sleep is less restless.

Improved behaviour and concentration

Treatment can noticeably improve daytime functioning, including behaviour and concentration. It can be good to check in with your child's teacher to see if they are noticing a difference in your child at school. 

Will my child accept the mask when using CPAP?

Often parents or caregivers are unsure if their child will accept the mask. This can take time for some children. It can depend on your child's age and level of understanding. Many children adjust quickly. Others may take a few days, weeks or months. The child health team caring for your child will support you and your child through this process. 

If it takes time for your child to wear the CPAP all night, keep encouraging them

CPAP is not a cure and sleep apnoea will return if your child stops using CPAP or doesn't use it correctly. To get the most benefit, it is important that your child wears the CPAP every night, for the whole time they are asleep. But, it may take some time before your child can manage this. If they won't wear it all night, keep encouraging your child to use the CPAP for as much of the night as possible.

Side effects from CPAP treatment

CPAP treatment may cause side effects in some children. These include a dry or stuffy nose, irritation of the skin on the face, and sore eyes due to air leaking around the mask. There are many options to solve these problems.

If your child has trouble with CPAP side effects, don't give up on the mask. Talk with your child health team as soon as possible. They will work with you to find solutions.  

Follow-up for children using CPAP

It's important to have regular contact with your child health team. In bigger centres, this will be a paediatric sleep clinic team. In smaller centres, it will be your usual paediatrician and outpatient nurse. 

They will check that the mask is fitting well, and the CPAP pressure is set correctly.

Regular appointments

Your child will need to see their hospital doctor for regular appointments - usually more frequently at the start but then every 6 to 12 months.

At each of these appointments, it's important to bring all the CPAP equipment (including the machine and mask). The child health team will check it still fits your child properly. They'll also do some regular maintenance. 

The data collected on the CPAP machine allows the doctor to track your child's progress. 

Sometimes, the child health team will download the data while you are at clinic. But more often now, they can check this information remotely through 'the cloud'.

They will contact you if there is something that needs adjustment.

Follow-up sleep tests

As your child grows, they may need follow-up sleep tests. This is to make sure the pressure from the CPAP machine is still right for your child.

Who to contact with concerns or questions

Please make sure you have clear information from your child health team about who to contact if you have problems with the machine, or you have concerns or questions about your child's treatment.

This will usually include a number to ring if you need help.

Accidents at home can happen in busy households. Your dog might chew the tubing! Your child health team will not be surprised if something like this happens. If this sort of thing does happen to you, please contact your child health team quickly so that your child's treatment isn't interrupted for too long.