Need help for 11 year old who can't keep mask on

I'm new to this forum and to using a CPAP. After several weeks of very dramatic parasomnia my son was diagnosed with Sleep Hypopnea. Although it is only moderate, the problem we are seeing is that he has extreme confusional arousals right when going to sleep (almost immediately within 1-5min), on waking up in the morning, and pretty much anytime he gets woken up. When these occur he is partially amnesiac (no idea who he is or who we are), panicky, sometimes aggressive, and they can last for hours if he doesn't go back to sleep.

When he is fully cognitive he has no problem putting on the CPAP mask and going to sleep, but I'm having a lot of difficulty getting it to stay on throughout the night. He will immediately wake up, panic, and rip it off. I've tried waiting until he's been asleep 15-30min and then briefly waking him to put it on. That has worked a couple times, but eventually after about 2 hours he'll wake up and rip it off again and anytime I wake him after that he is in a panicky state and won't wear it. Even if I can calm him down and get him to put it on, he'll fall asleep for about a minute and then wake up panicked again.

He is currently using a full face mask. Is there anything you are aware of that would be easier to sneak on a sleeping child without waking him up? Alternatively, any tricks for waking someone up out of this state and back into full cognition? We're hitting the end of our rope here....

Welcome to the forum. I can only imagine your desperation. In an effort to help, does your child have or had any other medical conditions? What medication(s) are you employing? Sorry for all the questions.

As far as a different mask, many people feel claustrophobic with a full face mask. I personally dislike the feeling of the temperature difference between inhale and exhale cycles on the face, not to mention the leaking from side sleeping. You might try a nasal or nasal pillow type of mask. The downside to these type of devices is the possibility of mouth breathing, thus requiring a chinstrap.

Good luck in your search for help. Hopefully somebody on this board is knowledgeable with your problem and can offer a lot better set of ideas than what I've presented.

Have you tried a different mask? Try a nasel pillow type.

We haven't yet tried a different mask, we were going to call up the provider today to get something else so I'll see about the nasal pillow one - thanks for the feedback!

He isn't on any medications yet. His first two days with the CPAP went fine and then things escalated from there. It was hoped that a few days of the CPAP would cause significant improvement, but I guess it hasn't.

Just a thought here, maybe not practical for an 11-year-old, but perhaps there is medication that could be prescribed to allow for longer period of sleep... I hate the idea of sleep medication, but in some instances I know of, it has helped people with various issues.

first give us the details of the machine. Hopefully it has data on it. Then you can load it into Sleephead ad SEE exactly what is happening when he removes his mask. Maybe the machine is not treating his events fast enough and he feels like he isn't getting enough air.

There are many well known, and some fairly rare sleep disorders, and if your son has not seen a neurologist I'd strongly suggest he do that. He may have been diagnosed with hypopneas, but I do wonder if he also doesn't have something else going on as well and suggest he be referred to a neurologist, pediatric or otherwise to make sure hypopnea is all that he has. But please do not try to diagnose him through the internet.

What is the health status of your son? Is he overweight? Is he healthy? Does he have allergies or a cold? Is he autistic? Is he on any medications?

How low does his O2 drop before he wakes up panicked WITHOUT the cpap? Get a pulse oximeter and record it. Use the ones that allow for a disposable finger sensor. You can get the sensor to fit perfect and tape it on.

I would say he might be having trouble breathing through his nose. Does he try to mouth breath or snore?

Have you had his vitamin D checked? Does he get out and get a good full body tan in the summer? Low vitaman D will mess with the sleep breathing brain control system. Many kids are getting low vitamin D because they don't get that much sun.

What machine are you using? You might want to try a bipap as it makes it feel easier to breathe. Keep in mind that if he can't breathe through his nose any cpap treatment is pretty much useless.

Troubleshooting cpap is bad enough for a person managing their own problems. Managing other people's problems is real hard. Most important thing is to make sure they can breathe through the nose. So you may want to watch them sleep or video record with a camera that has night vision and can record audio. Look for how they breathe and see if they twist and contort as they start to seek physical positions that will allow them to breathe. Watch the O2 level while you observe.

Waking kids up when they are asleep and they will be in another world. They may be even combative and violent as they will be quick to anger. Kids sleep is much sounder than an adults. So all that is normal. Waking up in a panic or from a nightmare is a good sign of problems breathing with or without cpap.

Can you go into more detail of the "After several weeks of very dramatic parasomnia" that you mentioned. Is this the first time? Describe the parasomnia more in depth. Will he talk about it. What does he do? Does he have a cold or alergy at this period of time.


Getting used to the mask being on the face is the first problem you deal with. That takes training and it may take a while. You must make sure that he can breathe through the nose. You may want to put a video camera with night vision so you can monitor him all night.

I know this post was from quite a while ago now, but I was wondering how this all worked out? Did he ever get used to sleeping with it on all night? My son is experiencing similar reactions to wearing it, waking up in a panic and ripping it off. He's fine putting it on before bed, and even claims to like it. But 2 hours in he wakes up and when I try to get it back on him he's flailing and screaming like he's living a nightmare.

Hi - it's quite possible his prescribed pressure level is inadequate (happens all the time when docs who understand 'apnea' do not understand the equipment at all and prescribe 'conservative' pressures without realizing people have a hard time managing. I'd want to know more about things, and if you can download Sleepyhead (many places on the forum to do that) and set up the results here we can advise about what's what (and if pressures need tweaking or not) and how to do what if necessary. It's a shame when children are not treated properly. Please tell us the full name/model of his machine, what mask he uses and the pressure(s) his machine's set at now. Also, is he using the ramp feature (many don't bother after the first week).