Frequently asked questions

Most children and teens are seen in CPAP clinic for the first time before getting their sleep machine at home. During this appointment you will meet with a nurse practitioner or doctor who will explain your child's sleep study results, diagnosis, and the recommended therapy. A respiratory therapist will fit your child with a mask and they will be able to try either CPAP or BiPAP™with the mask. You will take this mask home so your child can start practicing wearing the mask.

As they say, practice makes perfect! We recommend practicing with the mask every day with a goal of wearing it for 20-30 minutes at a time. Some children have to start slow, by wearing it about 5 minutes and then slowly increasing the time every day. Others can start wearing it for 20-30 minutes right away. It's best to have your child wear the mask during a favorite, quiet activity, like reading a book, watching TV, or playing a game. This teaching sheet can give you more details [English and Spanish].

Our team of doctors, nurse practitioner, respiratory therapists, and nurses are very experienced in helping children with a variety of special needs to be successful wearing either CPAP or BiPAP™. Of course, there are unique challenges for children and teens with special needs, but they can usually be overcome with teamwork and patience. Some children and teens respond well to preparing ahead for using CPAP or BiPAP™ by reading this social story.

The time it will take to get the CPAP or BiPAP™ machine depends on your insurance company. Some insurance companies require prior authorization and that can take several weeks up to a month. Other times the machine may be set up in as little as a week or two. Please call the home care company that will set up your child's CPAP or BiPAP™ machine if you have questions about when the machine will be set up.

After your child gets their CPAP or BiPAP™, a Sleep Center respiratory therapist will contact you by phone to talk about how your child is doing with wearing CPAP or BiPAP™. We may be able to solve simple problems over the phone.

Your child will be scheduled for a Positive Airway Pressure clinic appointment to see their doctor or nurse practitioner about 31 to 90 days after starting their therapy. This appointment is very important for your child to get the best health care, and some insurance companies require this appointment to continue paying for the machine.

After your first appointment, your doctor or nurse practitioner will discuss with you when to follow up next. Most children and teens will need to follow up every six months, but they may need to be seen more often in the beginning until they are able to use their therapy regularly.

Once your child has a CPAP or BiPAP™ machine, please bring your child's machine, power cord (both pieces), and any masks your child has to every CPAP clinic appointment. Even though your child's machine has a modem and the data can be downloaded remotely, it is very helpful to have the machine and mask at every clinic visit. It is similar to getting a tune up for a car. Without the car, the mechanic can't help fix any problems.

Insurance companies require patients to have an appointment in clinic within 31-90 days after starting CPAP or BiPAP™. If your child cannot make their appointment, it is very important if you call your CPAP team right away your CPAP team at (414) 266-4924. We can help you find another appointment within that time period.

All other appointments can be rescheduled by calling Central Scheduling at 414-607-5280.

You can reach our CPAP team at (414) 266-4924. Our respiratory therapists answer and check voicemail messages on this number regularly and they can contact your child's doctor or nurse practitioner, if needed.

It is very important that patients wear their sleep machine and mask every night. The goal is that they will be able to also wear it all night, but sometimes that takes a while. Even if your child struggles to get used to CPAP or BiPAP™, wearing it every night will help them to adapt more quickly. Do not take breaks from the CPAP or BiPAP™ on weekends or holidays.

CPAP and BiPAP™ manufacturers have apps that you can download on your smartphone or tablet. When you create an account and link your child's machine (by the serial number), you will be able to view their usage information. View more information if your child has a ResMed machine.

View more information if your child has a Respironics machine.

Your child's home care company will teach you how to clean the equipment. You can also find more information in the manual for the machine and the mask. However you can also use this quick reference guide.

Often the number for the home equipment company is on a sticker on their CPAP or BiPAP™ machine. If you can't find it, please call our CPAP team at (414) 266-4924 and they will give you the information to contact the company.

Your home care company should provide training for how to set up the CPAP or BiPAP™ machine. However, to review this process:

• ResMed machines
• Respironics machines

You can also read the machine manual for additional instructions.

You should call your child's home care company to order supplies. Some companies also have online ordering or an automatic supply option. Please ask them whether they have those options if you're interested.

When to replace worn out supplies:

1. Mask

• Mask cushion (nasal pillows): Every 1 month (as needed)
• Mask frame: Every 3 months
• Mask headgear: Every 6 months

2. CPAP or BiPAP™

• Tubing: Every 3 months
• Water chamber (humidifier): Every 12 months
• Air filter: Every 2 weeks (2 per month)

This can be a common side effect from CPAP or BiPAP™ therapy. If your child has red marks that fade within an hour or two, this is usually normal. Sometimes loosening the straps slightly can reduce red marks. A good rule of thumb is that if you can't fit two fingers under the straps on either side of the face, then the mask is too tight. If your child's mask is more than 3 months old, order a new mask from your home care company. An old mask can cause skin redness.

However, if you notice red marks that last many hours, open sores or blisters, or a rash, please call our CPAP team right away at (414) 266-4924.

Mask fit is one of the most important parts of CPAP or BiPAP™ therapy. Small adjustments to the headgear straps can stop some leaks. To troubleshoot mask fit, put your child's mask on and attach the tubing. Next, run the "mask fit" feature to check if the mask is sealing. (Check the machine manual for instructions on how to use this feature.)

If you feel a leak, adjust the headgear straps on both sides slightly tighter, making sure that the straps are not too tight. You can try to lift up on the mask cushion and let it gently rest back on the face to activate the seal.

If these suggestions don't fix the leak, please call our CPAP team at (414) 266-4924.

This can happen due to dry air from the CPAP or BiPAP™ pressure flowing through the nose. Often increasing the humidity setting can help or resolve this problem. If you need help with increasing that setting, you can call your home care company or our CPAP team at (414) 266-4924.

If you have already tried increasing the humidity, you could try an over-the-counter nasal saline spray or gel (like Ayr® gel which is approved for use with CPAP or BiPAP™) before bed and in the morning. Do not use Vaseline or petroleum-based products.

If your child gets a nosebleed that won't stop, seek medical attention.

Take a sip of water to see if that helps.

If your child has a nasal mask: If your child has a nasal mask and complains of a dry mouth, this means that the mouth is coming open during sleep. Sometimes this is due to a stuffy nose and a common cause of a stuffy nose is dry air. (see question above) If your child has been diagnosed with allergies, make sure that they are taking the allergy medication their doctor or nurse practitioner prescribed. If the above options don't work, your child may need to try a full face mask that covers both the nose and the mouth. You can call our CPAP team at (414) 266-4924 to see if that would be an option for your child.

If your child has a full face mask: Try increasing the humidity setting. If you have already increased the humidity, check for a mask leak. If there is a leak, the machine will try to make up for it by blowing more air. This can use up the water in the humidifier too quickly. If the above options don't work, please call our CPAP team at (414) 266-4924.

Some patients have trouble with "swallowing" air during the night, which can cause nausea, stomach pressure, burping, or gas. Check to see if your child's mask has a leak, because the machine will push more air in when there is a leak to try to make up for it. If your mask doesn't have a leak, please call our CPAP team at (414) 266-4924. If you have a child with a gastrostomy tube, please call our CPAP team to troubleshoot.

Devices using ozone or ultraviolet light to clean CPAP equipment are not currently approved by the FDA for this use. Also, use of an ozone cleaning machine could make the machine's warranty invalid. You can keep your child’s CPAP machine and supplies healthy and safe if you clean them regularly with soap and water. Read our cleaning instructions. 

It can take some time to adjust to wearing a mask at night. Some children need extra time and practice. Some helpful tips are:

• Have your child use the machine every day. If they only use it a few times per week, it is unlikely that they will get used to it.
• Be proactive in reminding your child and helping them. Even teenagers will need support and reminders from their parents to be successful in getting used to CPAP or BiPAP™.
• Try having your child use the machine and mask while awake, during a favorite quiet activity (like playing a game, watching TV, or reading a book) for about 20-30 minutes. This can help them get used to the feeling of the mask or the pressure.
• Talk to your child or teen and ask them what exactly bothers them about the mask or machine (for instance, "it's hard to breathe out" or "the mask hurts my nose"). Then call your CPAP team at (414) 266-4924 for ideas on how to make it more comfortable.

Regular CPAP clinic appointments are very important to help us decide when adjustments in the CPAP settings are needed as your child grows. We also use the CPAP downloads to help us decide if your child's settings are right. A sleep study to adjust settings may be recommended if your child has had a big change in weight or if your child is not tolerating the pressure.

• CPAP is set at a pressure that stays the same when a child breathes in and breathes out.
• BiPAP™ allows us to adjust the settings even more for your child. BiPAP™ gives extra support when a child breathes in. The BiPAP™ can also be set with a breathing rate to provide a different kind of support if a child has week muscles or has pauses in breathing.