CPAP mask for 12year old boy

Hey, folks, I have a situation here: completed a sleep study for my 12 year old, shows AHI 6. I asked the doctor's office for an appointment for mask fitting and a machine, but the office responded we would need a titration study.

BUT I don't want to wait: my son is autistic and has been overmedicated and is quite dysregulated and in much worse shape now than before the medication trials by his previous psychiatrist. Is there a way to bypass that sleep study? I could do that titration at home. Do CPAP supplies vendors require a script for masks? It's all I need for I already have a few spare machines.

A script is required for whole masks. You can buy the pieces off of amazon (ie frame, headgear and mask separately ). If your spare machines are respironics be aware of the recalls.

Yes, you can self-titrate with the help of people here. Just make sure that the machine you use is OSCAR compatible with full data reporting.

I would suggest the ResMed AirSense 10 (or 11) AutoSet

For a mask, I would suggest a ResMed AirFit P10. It's inexpensive, comes with three sizes (small, medium, and large) and is very minimal. Much less likely he'll take it off at night.

I heard that sleepweaver had some children's masks.
A cloth mask might be less disturbing for a sensitive child.

I second Dog Slobber's recommendation. It's a very personal thing, but the ResMed Airfit P10 really is about as minimalist as you can go. I've used that, and only that, for almost 6 years. If he gets used to it with low leaks, that might be just the ticket. Certainly won't make him feel to claustrophobic, I'd bet. I don't think CPAPSupplies requires prescription for anything but machines, I've purchased an entire P10 kit from them without one.

I don't think they take insurance, though, so there's that.

With autism there may be sensory issues that can make it difficult for your son to adapt to sleeping with the mask. That might be a reason to get a mask prescribed for him ahead of time--if he won't wear it during the titration study there's not going to be any useful information from going through a titration. So maybe they would be willing to prescribe the mask ahead of time so you can work on tolerance (and treatment--you don't have to tell them that) in the meantime, and you may not need to go through the titration.

You can buy masks online on eBay and Amazon. It's illegal to sell a complete mask without a prescription, BUT you can buy the parts and put a mask together. For example, you get everything (cushion, frame, hose) except the back strap, which you have to purchase separately.

There are pediatric masks as well if he's on the smaller side, but they are more difficult to come by without a prescription. Any doctor or dentist can write a prescription for "CPAP mask of patient's choice". Once you have that you can buy online, such as from our hosts at CPAP.com'

tan wrote: ↑

Mon May 08, 2023 10:42 am

Hey, folks, I have a situation here: completed a sleep study for my 12 year old, shows AHI 6. I asked the doctor's office for an appointment for mask fitting and a machine, but the office responded we would need a titration study.

BUT I don't want to wait: my son is autistic and has been overmedicated and is quite dysregulated and in much worse shape now than before the medication trials by his previous psychiatrist. Is there a way to bypass that sleep study? I could do that titration at home. Do CPAP supplies vendors require a script for masks? It's all I need for I already have a few spare machines.

Adenotonsillectomy is indicated in pediatric patients who have OSA due to adenotonsillar hypertrophy. This resolves OSA in most pediatric patients. I encourage you to have your son evaluated by an ENT.

tan wrote: ↑

Mon May 08, 2023 10:42 am

Hey, folks, I have a situation here: completed a sleep study for my 12 year old, shows AHI 6. I asked the doctor's office for an appointment for mask fitting and a machine, but the office responded we would need a titration study.

BUT I don't want to wait: my son is autistic and has been overmedicated and is quite dysregulated and in much worse shape now than before the medication trials by his previous psychiatrist. Is there a way to bypass that sleep study? I could do that titration at home. Do CPAP supplies vendors require a script for masks? It's all I need for I already have a few spare machines.

Clinical Laboratory Approaches for Diagnoses of Sleep-Disordered Breathing and ADHD-Like Behavior in Children
https://www.aafp.org/pubs/afp/issues/20 ... p1147.html
"The most common etiology of obstructive sleep apnea is adenotonsillar hypertrophy. Clinical diagnosis of obstructive sleep apnea is reliable; however, the gold standard evaluation is overnight polysomnography. Treatment includes the use of continuous positive airway pressure and weight loss in obese children. These alternatives are tolerated poorly in children and rarely are considered primary therapy. Adenotonsillectomy is curative in most patients."

Also, there's evidence suggesting behavioral problems can be exacerbated by SDB in children.

"Laboratory tests that correlate with both OSA and ADHD-like syndromes would be useful to diagnose root causes of behaviors and identify a subset of children who may not need psychotropic medications"

I think you should get a hold of the sleep study and find out what the AHI is composed of and if it's something that the medication is causing (i.e., poor sleep and post-arousal stuff, central depression, etc.).

If it is post-arousal/poor sleep, then CPAP will make it worse.

Specifically what medications.

If the problem is caused by overmedication, then treatment isn't with an xPAP, it's review and revise medication.

tan wrote: ↑

Mon May 08, 2023 10:42 am

...12 year old, shows AHI 6.

Also, the OSA criteria for children is substantially different from adults, so you gotta think about what you're doing.

On the NPSG, see what ETCO2 is.

Callen wrote: ↑

Mon May 08, 2023 9:30 pm

I encourage you to have your son evaluated by an ENT.

Yes, very important to get an evaluation by an ENT.

Rubicon wrote: ↑

Tue May 09, 2023 2:10 am

Also, the OSA criteria for children is substantially different from adults, so you gotta think about what you're doing.

I'm glad you are active in the forum on the more complicated cases.

Rubicon wrote: ↑

Tue May 09, 2023 2:10 am

tan wrote: ↑

Mon May 08, 2023 10:42 am

...12 year old, shows AHI 6.

Also, the OSA criteria for children is substantially different from adults, so you gotta think about what you're doing.

On the NPSG, see what ETCO2 is.

This is the only summary that I have at this moment: I see a couple of centrals and no RERAs and it looks like OSA overall (mostly apneas and hypoapnea). The report says 0 medication, but he was on ativan (2mg/d) and zyprexa (10mg/day). Could it explain the latency to REM?


TcCO2 was ordered but I don't have a full report yet. UPDATE: doctor said CO2 was normal during the follow-up.

ChicagoGranny wrote: ↑

Tue May 09, 2023 7:56 am

Callen wrote: ↑

Mon May 08, 2023 9:30 pm

I encourage you to have your son evaluated by an ENT.

Yes, very important to get an evaluation by an ENT.

ENT evaluation is a month away and potential relief (surgery) is even more so. He's been out of school more than 6 months and complains of being worried all the time. I insisted on having a sleep study, but, unfortunately, a little too late. Medication trials had commenced earlier than that.

JOinPA wrote: ↑

Mon May 08, 2023 6:25 pm

I second Dog Slobber's recommendation. It's a very personal thing, but the ResMed Airfit P10 really is about as minimalist as you can go. I've used that, and only that, for almost 6 years. If he gets used to it with low leaks, that might be just the ticket. Certainly won't make him feel to claustrophobic, I'd bet. I don't think CPAPSupplies requires prescription for anything but machines, I've purchased an entire P10 kit from them without one.

I don't think they take insurance, though, so there's that.

P10 is how I started a long time ago, had bad leaks and settled on a full face mask. I guess we'll start with a P10, if it comes to that.

Janknitz wrote: ↑

Mon May 08, 2023 6:57 pm

With autism there may be sensory issues that can make it difficult for your son to adapt to sleeping with the mask. That might be a reason to get a mask prescribed for him ahead of time--...

Yes, I have been thinking of the same: about to ask for a mask in advance in a follow-up today, because the previous study was about to fail but miraculously went through. I can't expect the same luck next time.