Continuous positive air pressure (CPAP) therapy is widely used to alleviate symptoms of sleep apnea, a condition characterized by heavy snoring and temporary loss of breath during the night. Millions of adults have been diagnosed with sleep apnea. Additionally, roughly 1 to 4 percent of children experience apnea symptoms before reaching adulthood.
Best CPAP Masks for Children in 2021
- Editor’s Pick – ResMed Mirage Kidsta CPAP Mask and Headgear
- Best Lightweight Mask – ResMed Pixi CPAP Mask and Headgear
- Best Mask for Toddlers – Philips Respironics Wisp CPAP Mask
For most children, enlarged tonsils and/or adenoids are the root cause of sleep apnea. Removal of the tonsils and adenoids can reduce, if not eliminate, apnea symptoms. However, children who continue to experience sleep apnea may qualify for CPAP therapy. CPAP can also help children who experience apnea due to other reasons, such as obesity or an enlarged tongue.
CPAP therapy involves a machine that draws in outside air, humidifies and pressurizes the air, and then delivers it to the child through a connective hose and breathing mask. Mask choice is critical for children with apnea. Many experience facial discomfort when using large/heavy masks, and some mask models are designed for easier breathing through the nose and/or mouth than others. It’s important to note that, by law, purchasing a CPAP mask requires a doctor’s prescription.
This guide will look at common designs for children’s CPAP masks and provide some tips for choosing a suitable model. Below, we’ll go over our top three picks for children’s CPAP masks sold today. These selections are based on verified customer and owner experiences, along with our own product research and analysis.
Editor’s Pick – ResMed Mirage Kidsta CPAP Mask and Headgear
- Nasal cradle mask
- Silicone cushion
- Click-on headgear
- For children 7 and older
- 90-day warranty
Get the best price on a ResMed Mirage Kidsta CPAP Mask and Headgear.
Editor’s Pick Overview
Many children struggle with CPAP therapy due to the size, shape, and appearance of their breathing mask. The ideal CPAP mask for children should be non-invasive, lightweight, and fairly minimalist to ensure proper use and compliance.
For our Editor’s Pick, we’ve selected the ResMed Mirage Kidsta. This nasal cradle mask is outfitted with silicone wall cushions for added padding and comfort. The mask does not hinder the child’s line of sight. Its frame is also very lightweight and specifically sized for smaller facial dimensions. The mask also comes with headgear that can be adjusted and set into place with easy click-on parts.
The ResMed Mirage Kidsta is widely available for less than $100, making it very reasonable in terms of cost. ResMed also offers a 90-day warranty.
Best Lightweight Mask – ResMed Pixi CPAP Mask and Headgear
- Nasal cradle mask
- Silicone cushion
- Light neoprene headgear
- For children 2 and older
- 90-day warranty
Get the best price on a ResMed Pixi CPAP Mask and Headgear
Best Lightweight Mask Overview
Most pediatric CPAP masks are lightweight by design, since most children cannot bear the same amount of weight as adults. The ResMed Pixi is our pick for Best Lightweight Mask largely due to its headgear, which is made of soft neoprene that weighs much less than plastic and other headgear materials. This allows children 2 and older to use the mask.
The ResMed Pixi is a nasal cradle mask cushioned with silicone on both sides for added comfort. The headgear does not block line of sight, which can be helpful for exceptionally young children who find bulky, obstructive masks intimidating. A quick-release button allows the child and their parents to quickly remove the mask in the event of an emergency. The connective hose can also be positioned on either side of the face.
Like the ResMed Mirage Kidsta, the Pixi is very reasonably priced – expect to pay less than $120 for the mask and headgear. The product is also backed by a 90-day warranty.
Best Mask for Toddlers – Philips Respironics Wisp CPAP Mask
- Nasal cradle mask
- 3 sizing options
- Click-on headgear
- For children weighing 22 lbs. or more
- 2-year warranty
Get the best price on a Philips Respironics Wisp CPAP Mask.
Best Mask for Toddlers Overview
Many CPAP masks – even children’s models – are not sized for toddlers because sleep apnea is rarely diagnosed in children under 3 years of age. The Wisp CPAP Mask from Philips Respironics is a notable exception. This model comes in three sizes, including a small size option for children as light as 22 pounds. Medium and large sizes are also available for larger toddlers.
The mask and its headgear are designed with a fun giraffe print that should help toddlers acclimate to CPAP therapy without fear or anxiety. Soft silicone cushions pad both sides, making the mask comfortable for all wearers. The headgear has one-click locking mechanisms for easy adjustments, as well as a leak correction dial to loosen or tighten the mask whenever airflow is compromised.
The Philips Respironics Wisp is somewhat expensive compared to other children’s CPAP masks, with a typical price-point of about $150. However, the product comes with a two-year warranty, which is longer than average.
- Side and back sleepers in all weight groups (light, average, heavy)
- Those who like the close conforming of memory foam
- Back pain sufferers
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: Sleepation.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.
|CPAP Mask Type||Full Face||Nasal Cradle||Nasal Pillow|
|Appearance||The mask forms a seal from the bridge of the nose to the chin, covering the entire nose and mouth||The mask forms a seal from the bridge of the nose to the upper lip, with a chinstrap to keep the jaw closed||The mask fits into both nares (nostril openings), but does not cover any other part of the nose or mouth|
|Size/Availability||Widely available in men’s and women’s sizes Pediatric sizes are very rare||Widely available in men’s and women’s sizes This is the most common mask type for children||These masks are somewhat rare in men’s and women’s sizes Virtually non-existent for children|
|Pros for Child Users||Straps and headgear keep the mask in place if the child tosses and turns This is the best option for children who struggle breathing through their nose and/or those who primarily breathe through their mouth||Because this is the most common mask type for children, buyers can choose from a fairly wide selection of brands and models This is the best mask design for children who primarily sleep on their sides||This is the least expensive and invasive CPAP mask type|
|Cons for Child Users||The masks can be somewhat heavy and bulky The effect of wearing a full face mask can have a jarring effect on children, particularly those under the age of 5 Full face masks in child sizes are very rare||The mask can cause some irritation where the mask and headgear come into contact with the face||The mask’s design can lead to nasal dryness, nosebleeds, and other uncomfortable side effects Nasal pillow masks are not generally made for children|
|Average Price Range||$80 to $150||$80 to $120||$50 to $75|
As you can see from the table, a nasal cradle mask will most likely be the most suitable option for a child receiving CPAP therapy. Our top picks reflect this, as all three are nasal cradle masks.
CPAP Mask Prescription FAQ
Next, we’ll answer some common questions about prescription requirements for pediatric CPAP masks.
|Does my child need a prescription for their CPAP mask?||Yes. The CPAP mask, along with the machine and humidifier components, are classified as Class II medical devices by the Food and Drug Administration (FDA). And as such, the FDA regulates the sale of these devices. Other CPAP components, such as the connective hose and the machine’s air filter, do not carry this classification and will not require a prescription.|
|Can I buy a pediatric CPAP mask without a prescription?||Yes, but this is against the law. Any individual or organization that sells CPAP masks must first receive FDA approval to do so. And because the CPAP mask is a Class II medical device, the FDA will only grant permission to sellers who require a prescription from buyers. That being said, CPAP masks may be sold illegally without a prescription. This is commonly found on private online marketplaces like Craigslist. In addition to being illegal, these sorts of transactions are ill-advised. The buyer receives no warranty or guarantee that the mask will be in working order, and many resold models have been refurbished or modified from their intended design. Additionally, the mask may have been exposed to germs and bacteria from previous users. Bottom line: never buy a CPAP mask from a seller that is not FDA-approved.|
|Who can write a prescription for my child’s CPAP mask?||In order to be considered valid, CPAP mask prescriptions must come from one of the following licensed or certified medical professionals: -Medical physician, pediatric physician, or physician’s assistant -Doctor of osteopathy -Naturopathic physician -Nurse practitioner -M.D. psychiatrist -Dentist Most FDA-approved CPAP mask sellers will not accept prescriptions from chiropractors, optometrists, or psychologists.|
|What does the pediatric CPAP mask prescription need to say?||The prescription must include the following: -Physician’s contact information and signature -The patient’s legal name -A phrase that specifically indicates the type of therapy being prescribed, such as “CPAP mask,” “CPAP,” “BiPAP mask,” or “BiPAP.” In some cases, the prescription for the CPAP machine/humidifier will also be sufficient for the pediatric CPAP mask. Consult your pediatrician or family doctor for more information.|
Tips for Helping Children with CPAP Therapy
Many children struggle with the loud noises, bulky headgear, and airflow delivery of CPAP therapy. The following strategies can alleviate some of the child’s fears and anxieties about using CPAP equipment, and also help parents mitigate their child’s apnea symptoms.
- Practice with the Mask During the Day: Children’s Health recommends daytime therapy for first-time CPAP users. This allows children to acclimate to the sounds and sensations while they are awake, rather than at night when they are supposed to be falling asleep.
- Impose Strict Rules about Mask Removal: Removing a CPAP mask during the night will interrupt airflow and result in little to no therapy, which in turn can lead to more apnea episodes. Children may be tempted to remove their mask if they feel uncomfortable or scared during the night. Children’s Health recommends strict rules against this to avoid reinforcing unhealthy habits.
- Invest in a Sleep Apnea Alarm: Sleep apnea alarms are primarily designed for very young children with the condition. The alarm will issue an audible alert whenever an apnea episode occurs, which will awaken the child and end the episode.
- Maintain Good Ventilation Inside the Home: Parents can also assist children with sleep apnea by maintaining a healthy indoor environment free from allergens and pollutants. The Mayo Clinic notes that parents of children with sleep apnea should never smoke indoors. In-home humidifiers can also keep air fresh and contaminant-free during the day.
If your child has sleep apnea and struggles with CPAP therapy, talk to your family doctor about other tips and strategies to help them acclimate to CPAP in a healthy, responsive way.
Additional Sleepation Resources
For more information about CPAP masks and other aspects of CPAP therapy, please visit the following guides on Sleepation.com: