Continuous positive airway pressure (CPAP)

  • Continuous positive airway pressure (CPAP) is a therapy that relieves upper airway obstruction (blockage) during sleep. It involves delivering normal air to your child's airway at a set pressure, which keeps the airway open and prevents airway obstruction.

    CPAP is most commonly used in newborns with breathing difficulties, but is also used to treat severe obstructive sleep apnoea (OSA) and other airway disorders. This fact sheet focuses on its use as a treatment for OSA.

    The air is given to your child through a mask attached to an electrically powered machine called a CPAP driver. The mask may cover the whole face, the nose and mouth or just the nose, or it might simply consist of prongs into the nostrils. It is held in place by a little cap (headgear) or straps.

    Why does my child need CPAP?

    If your child has OSA they may benefit from CPAP. OSA is a medical condition that causes breathing difficulties during sleep, caused by partial or complete obstruction of the upper airway. Symptoms include snoring, pauses in breathing or difficulty breathing, restless sleep and daytime tiredness. OSA can impact on your child's health and development, and may lead to growth, learning or behavioural problems.

    CPAP prevents upper airway obstruction and helps control OSA. Benefits may include:

    • reduced disruption to sleep
    • improved sleep quality
    • snoring is reduced or stopped
    • reduced daytime sleepiness
    • reduced headaches caused by OSA.

    Getting started on CPAP 

    Your child will come to hospital to have a mask fitting. Once they are comfortable wearing the mask during sleep, an overnight polysomnography (a sleep study) is arranged to check the optimal CPAP pressure for your child.

    Before the sleep study, wires will be attached to your child's skin to measure their sleep and breathing patterns. Staff will make sure that the mask fits comfortably (and will also teach parents or caregivers how to fit the mask) and monitor how well it is tolerated throughout the night.

    Using CPAP at home

    Many parents are unsure if their child will cope with the mask. However, once home, most children do tolerate CPAP well, as they find it gives them relief from their OSA symptoms. Many children adjust very quickly and begin wearing the mask all night long quite soon, while others may take a few days, weeks or months.

    For the greatest benefit, CPAP should be used all night, every night. However, 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.

    Follow-up 

    • Your child will need to be reviewed by their respiratory specialist at regular intervals – usually every three to six months.
    • At each of these appointments, it's important to bring all the CPAP equipment (including the machine and mask) so staff can check it still fits your child properly and perform some regular maintenance.
    • The SD card from the CPAP machine will be downloaded each time your child is reviewed so the doctor can monitor your child's progress.
    • For those on long-term CPAP, annual follow-up sleep studies are recommended. As your child grows, the annual follow-up will ensure the pressure from the CPAP machine is still correct. 
    • Contact your treating hospital if you have concerns or questions about your child's treatment.

    Key points to remember 

    • CPAP involves giving normal air from the room at a set pressure through a mask.
    • Obstructive sleep apnoea (OSA) is a medical condition that causes breathing difficulties during sleep.
    • CPAP prevents airway obstruction and controls OSA.
    • CPAP should be used all night, every night for the greatest benefit.

    For more information

    Common questions our doctors are asked

    Will my child with OSA ever be able to stop using the treatment?

    CPAP controls OSA, but does not cure it. The decision for your child to continue or stop using the CPAP is very individual and may relate to what caused the OSA and whether any other treatment is available. Discuss this with your child's doctor.

    My baby is currently in newborn intensive care, will they need CPAP forever?

    CPAP is commonly used in newborn babies, for various breathing problems (prematurity, meconium aspiration, hyaline membrane disease, transient tachypnoea of the newborn, etc). Most babies are only on CPAP for short periods, before moving to less intensive breathing support, or without support entirely, once they become older and stronger.


    Developed by The Royal Children's Hospital Respiratory Medicine department. We acknowledge the input of RCH consumers and carers.

    Reviewed July 2018.

    This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


Disclaimer  

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.