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Practice with the mask when your child is in a good mood.
Practice 2-3 times per day.
It may take a while for your child to get used to the mask and before getting used to the mask there will likely be some resistance from your child.
Keep the goal of improving your child’s breathing during sleep in mind when you feel frustrated during the process or when your child pushes back.
Provide a lot of positive feedback and try to remain very calm during the process.
Other tips that can help to get ready for CPAP/BIPAP usage:
Let your child touch the mask and hold the mask to their face while you provide positive feedback.
Place mask on stuffed toy animal or doll.
Decorate the machine with stickers or even give the PAP machine a name. Please don't apply stickers to the mask.
Put mask on parent's nose or have parents wear silly noses.
Have CPAP/BIPAP machine running in background while you practice so child can get used to the noise.
Remain calm when practicing and maintain matter-of-fact voice.
Praise your child frequently even with small improvements.
How to put the mask on your child
Approach your child from the front and never from the back.
Tell your child that you will place the mask on her/his face and that it will tickle a bit initially but feel fine soon.
Make eye contact with your child and continue talking to him/her.
Slowly place mask on child’s face and keep it there initially for just 5-10 seconds while providing lots of positive encouragement. Remind your child to breathe in and out.
Gradually increase time to 1 minute.
Once your child can have the mask on his/her face for 1 minute, put the mask on the child’s face and pull headgear slowly over head to secure mask without you having to hold it. This should be done with the mask not attached to the tubing and machine and with the air flow off.
If your child resists, you might have to gently redirect her/his hands and place mask on while calmly talking to your child and release hands once she/he calms down.
Add a rewarding activity, i.e. reading favorite book, favorite TV show or movie once your child keeps the mask on.
You may have to repeat these steps many times as your child learns to be comfortable with the mask.
Once your child can keep the mask on for a minute or two for a few days in a row, connect to machine and repeat the process. Once your child tolerates the mask while connected to the machine, it is time to start putting it on at bedtime.
It might take 2-4 weeks for this process. Remember to remain calm. Give praise for progress. Try to end each session with a success, even a small one. CPAP/BIPAP should be part of a good bedtime routine involving:
Consistency each night
A relatively cool, quiet, almost dark room
Getting your CPAP /BIPAP machine ready to use at night and putting the mask on should be part of this nightly routine just like other bedtime activities such as putting on pajamas, brushing teeth, reading a book or singing a song
How to ensure continued therapy
Wear the mask every night. Avoid taking “vacations” from CPAP, including during grandparent or out-of-town visits.
Incorporate placing CPAP on during your bedtime routine.
Continue to praise your child for wearing the mask.
Keep a sticker chart to record your child’s progress with prizes every 1-2 weeks. The prizes can be a special outing with parents or the child picking a movie for family night, not necessarily things to buy your child.
Contact your medical equipment provider at least every six months for a new mask, sooner if the mask is breaking down or uncomfortable for your child.
Replacement cushions for the CPAP mask can be obtained every month if needed.
If the head gear seems to be getting stretched out or not fitting, contact your medical equipment provider or consider adding extra Velcro to straps to improve fit.
For your insurance company to continue payment of the machine and supplies, most insurance companies require that your child use the machine consistently for at least 4 hours per night most nights. With consistent use, your child will be more rested so you and your child will notice benefits to the use of PAP.