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 be introduced to a staff member from the sleep team either by telephone or face to face to discuss the plans for therapy to commence.
Planned Admissions
Most children have CPAP therapy commenced in hospital and your child would be required to stay for approximately 3 - 4 nights. During this time the team will find a suitable mask for your child to use and work out the best pressure settings for your child. You will be reviewed by the sleep team each day to receive education on using CPAP and make sure that you and your child are comfortable using the equipment.
Home initiation of therapy
Children who live close to the hospital may be suitable to start the CPAP in their home with the assistance and support of our HITH (Hospital in the Home) nurses. The sleep team will discuss with you to see if your child is suitable for this to occur.
Your child will need to attend the hospital to 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. You will be required to rent a CPAP device from a local supplier during this time and the sleep team will support you with this. You will be contacted by the HITH team and a date for commencement of therapy will be negotiated.
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 $200 - $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 may be required to use the CPAP for a few weeks post the operation
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 6-12 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.
Other comments
When your child is discharged home on CPAP, you may be eligible for the ‘Essential Medical Equipment Payment’ at Centrelink if you hold a health care / carers card. This is an annual payment. 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. A portable battery can be purchased at your expense and the sleep team will advise you of the process for this. The sleep team will provide you with an Electricity Rebate Form. By submitting this to your electricity company, you will be entitled to a rebate on your bills and automatically placed on the ‘priority list’ for reconnection in the event of power outages at home.
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.
Contacts
- Scientific Officer (02) 9845 1851/ (02) 9845 2107
- Registered Nurse (02) 9845 0545
- Clinical Nurse Specialist (02) 9845 0230
- Clinical Nurse Consultant (02) 9845 2572
- Biomedical Engineering Department (02) 9845 2602
Acknowledgement for images
Philips Home Healthcare - customer care number 1300 766 488
Devilbiss Healthcare Australia
Remember:
- 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.
