Buying Guide – How to Shop for a Child's CPAP Mask
Sleep apnea affects millions of adults, and many children are also diagnosed with the condition. Many doctors seek alternative treatments for their young patients, but if symptoms persist then CPAP therapy will likely be the most effective option.
CPAP therapy can be scary and intimidating for some children. The machines used during therapy can be loud and disruptive to sleep. Additionally, the breathing masks required for CPAP can be invasive, uncomfortable, and somewhat jarring – especially for very young children.
This guide will discuss how CPAP masks work and which designs are best for children. We’ll also cover prescription requirements and some tips for assisting children with CPAP therapy.
Please note: Tuck.com is not a medical website. Our tips about children’s CPAP masks should never replace advice from a licensed physician. If your child has been diagnosed with sleep apnea or you believe they are showing symptoms of that condition, please speak with your doctor about mask recommendations and other aspects of your child’s health.
Diagnosing and Treating Sleep Apnea in Children
Approximately 1 to 4 percent of children in the U.S. have been diagnosed with sleep apnea. Of these cases, many fall between the ages of 2 and 8.
Sleep apnea is a condition characterized by temporary loss of breath during sleep, as well as heavy/chronic snoring. Although specific symptoms vary by patient, there are two general types of sleep apnea based on root cause. Obstructive sleep apnea (OSA) occurs due to a physical obstruction blocking the airway. Central sleep apnea (CSA) occurs when the brain is unable to signal the muscles that control breathing.
Pediatric Sleep Apnea Symptoms
Pediatric sleep apnea is the name for sleep apnea that affects children. The root causes for pediatric sleep apnea differ from those for adult sleep apnea. According to the Mayo Clinic, pediatric OSA often occurs due to one or more of the following:
- Enlarged tonsils and/or adenoids
- Enlarged tongue
- Skull or face abnormalities
- Being overweight or obese
- Nasal congestion
- Medical conditions such as cerebral palsy, Down syndrome, or sickle-cell anemia
- Low birth weight
The Colorado Children’s Hospital also notes the following causes for pediatric CSA:
- Heart conditions
- Premature birth
- Birth defects
Pediatric OSA and CSA are both characterized by the following symptoms:
- Loud snoring
- Choking or coughing during sleep
- Night terrors
- Daytime fatigue
- Difficulty napping and/or waking in the morning
Pediatric Sleep Apnea Diagnosis
Regardless of the child’s age, parents should consult a doctor if they notice sleep apnea symptoms. Most physicians will discuss symptoms with the child and their parent(s), conduct a physical exam, and, if need be, order a sleep study for the patient.
Most sleep studies require the child to stay overnight in a hospital or specialty clinic. Technicians monitor the child’s brain waves, oxygen levels, heart rate, muscle activity, and breathing to discern whether or not they have sleep apnea.
Alternatively, doctors may prescribe an oximetry, or take-home, sleep test. However, oximetry tests tend to yield inconclusive results, so an overnight sleep test may also be needed. Doctors may conduct an electrocardiogram test, as well, since heart conditions have been linked to pediatric sleep apnea.
Treating Pediatric Sleep Apnea
Children with mild sleep apnea symptoms may not necessitate treatment. In fact, many outgrow their symptoms by the time they reach adulthood. However, many physicians elect to monitor the child’s symptoms to ensure no long-term complications.
For others, the Mayo Clinic notes that the following treatment methods may be needed:
- Topical Nasal Steroids: These medications include fluticasone and budesonide. They do not prevent or reduce sleep apnea episodes, but they can alleviate heavy nasal congestion that exacerbates apnea symptoms. Topical nasal steroids are usually prescribed as a short-term solution.
- Tonsil and Adenoid Removal: Most children are born with two tonsils, masses of soft tissue located at the back of the throat. Similarly, most have two adenoids, soft tissue masses located at the back of the nasal cavity. Many children have their tonsils and adenoids removed during childhood because they can become enlarged, leading to health issues such as OSA. Their removal can open up the airway and significantly reduce sleep apnea episodes.
- Weight Loss Regimen: For children who experience sleep apnea due to being overweight or obese, most doctors will help their parents create a fitness and diet plan to help the patient lose excess weight. Many children with sleep apnea find their symptoms decrease with weight loss, and these symptoms may also return if they regain the weight.
- Oral Mouthpieces: Certain anti-snoring mouthpieces can help open up the airway and reduce apnea episodes in children. These include mandibular advancement devices (MADs), which physically move the jaw forward and hold the tongue in place to prevent air blockage, and tongue retaining devices (TRDs), which hold the tongue in place to maintain an open airway. These appliances can be effective, but also painful and impractical for children who are still growing.
CPAP therapy may, under some circumstances, be the best option for children with sleep apnea. The therapy is commonly prescribed for:
- Children who have had their tonsils/adenoids removed and still experience apnea symptoms
- Children who are awaiting tonsillectomy/adenoidectomy procedures, or those who cannot undergo these surgeries for medical reasons
- Overweight or obese children
- Children with facial deformities or abnormalities causing airway blockage that cannot be surgically corrected
- Children with CSA
CPAP Therapy and Mask Overview
CPAP therapy involves air that has been pressurized to a fixed setting. This setting, listed in the CPAP prescription, is based on the patient’s sleep apnea symptoms and breathing patterns. The air is also humidified using a built-in or external humidifier. For this reason, the air delivered during CPAP therapy is measured in centimeters of water, or cmH20.
Many people have different breathing patterns during inhalation and exhalation. Because CPAP therapy involves one fixed setting, it can cause discomfort for some users – particularly during exhalation. Bi-level positive air pressure (BiPAP) therapy includes two fixed pressure settings, one for inhalation and another for exhalation, which can help some users breathe more easily. For some children, BiPAP therapy may be the most suitable option, though it is not prescribed to treat pediatric sleep apnea as often as CPAP therapy.
A third option, automatic positive air pressure (APAP) therapy, does not have a fixed pressure setting. Instead, the machine will adjust pressure settings throughout the night based on the user’s breathing patterns. However, APAP is a fairly new alternative to CPAP and has not been extensively studied with regard to pediatric sleep apnea.
CPAP, BiPAP, and APAP therapy require the following hardware components:
- CPAP Machine: The CPAP machine collects outside air using a built-in fan, and then humidifies the air and pressurizes it to a certain setting. The machine also has a filter to remove dust and other contaminants from the air. Most CPAP machines can pressurize air between settings of 4 and 20 cmH20, while most BiPAP and APAP machines have wider ranges (usually 3 to 25 cmH20). Children generally require lower pressure settings.
- Humidifier: The CPAP machine may have a built-in humidifier, or it may be compatible with an external or integrated humidifier. The humidifier helps freshen the air before it is delivered to the user. This can alleviate congestion, runny nose, and other side effects of CPAP therapy. Select CPAP machines are designed for use without a humidifier.
- Connective Hose: The connective hose – typically made from nylon or silicone – links the CPAP machine to the child’s breathing mask. The hose is usually 6 to 7 feet in length. Unlike the CPAP machine, humidifier, or breathing mask, the connective hose does not require a prescription for legal purchase.
The CPAP machine, humidifier, and connective hose are usually sold together as one unit. The final component of CPAP therapy is the breathing mask, which is sold separately from the others. The mask also requires a prescription.
Every mask model is unique, but most CPAP masks sold today fall into one of three general categories: full face, nasal cradle, or nasal pillow. It’s also important to note that most breathing masks are universally compatible with all CPAP machines, as well as BiPAP and APAP machines. The table below outlines the differences between these three mask types.