What is CPAP?
CPAP (Continuous Positive Airway Pressure) is a type of respiratory support therapy used to overcome obstruction of the airways. It involves the use of a CPAP mask and machine. The CPAP machine uses air pressure to keep the airways open during sleep.
Why does your child need CPAP?
Your doctor has told you that your child has a breathing disorder called Obstructive Sleep Apnoea (OSA). Symptoms of OSA include snoring, pauses in breathing, waking at night, bed wetting, poor concentration and hyperactivity. OSA can be caused by a number of things including large tonsils and adenoids, a cleft palate, muscle weakness, being overweight, having narrow airways or lung disease. For this reason your child will be required to use CPAP every time they sleep (including daytime naps).
The use of CPAP opens the airways to stop the snoring and allows normal breathing to occur. Normal breathing is important as it helps deliver oxygen and removes carbon dioxide.
What will we do?
Once it has been decided that your child needs CPAP you will meet with the Clinical Nurse Consultant, or the Scientific Officer from the Respiratory Support Service, or a member from the Sleep Unit.
During this appointment your child will be fitted with a CPAP mask. Your child needs to get used to wearing the mask before CPAP treatment can start. You will take the mask home and over the next few days encourage your child to wear the mask for short periods of time. This can be when your child is either awake or asleep, as the goal is to ensure that your child is not afraid of the mask.
We will take a 3D photograph of their facial bones before starting treatment. This will help us to monitor the growth of the bones and make sure that the mask is not pressing upon the top teeth. With continuing mask and pressure treatment, this 3D photograph should be repeated every 2-3 years.
Once your child is happy wearing the mask, call the Scientific Officer and we can book you in for admission to hospital to commence CPAP. The hospital admission will be for approximately 3 - 4 nights. During this time the team will work out the best pressure settings for your child and you will receive education on CPAP. During this time you will be required to hire all CPAP equipment for home.
Some children who live close to the hospital can start the CPAP in their home with the assistance of our home nurses.
How do you get the mask and machine?
When your child is first established on CPAP you pay a fee for the mask at The Children’s Hospital at Westmead. This fee is a single payment of $100 and must be paid at the Cashier (next to the Emergency Department). With the exception of children under the age of 6 months, any additional masks must be bought at retail outlet centres. The retail price of a mask is approximately $250 - $300. We will give you the details you need to purchase future masks from a retail outlet.
The Children’s Hospital has a limited supply of CPAP machines. For this reason you will be required to rent or purchase the machine. There are many outlets that provide this and you will be provided with the contact details of these outlets. Hire costs vary depending upon the type of machine your child requires. Please advise us if you have a health care card, so we can assist any application for purchase or funding.
How long will your child need to use CPAP?
If your child has sleep apnoea and is awaiting surgery (e.g. the removal of adenoids and tonsils) then CPAP may be needed as a short-term solution until the day of surgery. In some cases the surgery will fix sleep apnoea and CPAP will no longer be needed.
Some children continue to have sleep apnoea after surgery and will need to use CPAP as a long term treatment. For some children we know CPAP will be needed long-term because surgery is not a treatment option. In these cases your child will need to see their Sleep/Respiratory doctor every 3 – 6 months (as instructed by your Sleep doctor). Your child will also need to have further sleep studies every 6 - 12 months. The use of repeat sleep studies allows us to monitor the progress of your child’s sleep breathing and the need for CPAP.
When your child is discharged home on CPAP, you are eligible for the ‘Essential Medical Equipment Payment’ at Centrelink. This is an annual payment of $140. An application needs to be completed by you and your doctor to take to Centrelink.
CPAP machines do not have internal batteries. You must be aware of this as it will stop working in the event of a blackout. You can purchase a 12V battery and/or contact your electricity supplier. By contacting your electricity supplier you can notify them that a family member is on CPAP and request to be put on a ‘Priority List’ in the event of a blackout. By notifying your electrical supplier you are also eligible for a discount on your electricity bill.
What if your child becomes unwell at home?
If your child gets sick and needs to come to the Emergency Department you will need to bring all CPAP equipment with you.
If your child is breathing rapidly, noisily or seems to be having difficulty breathing you should see a doctor urgently.
If the problem is very severe you may see a dusky colour around your child's lips or there may be pauses when they stop breathing. You should call an ambulance (000) if this occurs.
RSS Scientific Officer (02) 9845 1851
RSS Clinical Nurse Consultant (02) 9845 2572
Respiratory Support Service (02) 9845 3437
Biomedical Engineering Department (02) 9845 2602
Acknowledgement for images
Philips Home Healthcare - customer care number 1300 766 488
Devilbiss Healthcare Australia
- Your child needs to use CPAP every time they sleep (day and night).
- Your child will need to get used to wearing the mask at home before we commence CPAP in hospital.
- You will be required to rent or purchase the CPAP machine. You will be required to purchase replacement CPAP masks.
- Children using CPAP need regular follow-up appointments with the Sleep doctor.