What happens when my child needs a breathing mask (NIV, CPAP) at night?

Hello, I’m Phil Davies, I’m a children’s
chest doctor and I look after children who have problems with breathing at nighttime Together we’re going to show everybody what happens when a child
needs to start on non invasive mask ventilation So, why would anyone need a
breathing mask at night? Well, some children do have problems with their breathing at nighttime If that happens and we worry about that we organise them to have a detailed sleep study and if it shows that there is in fact a real problem there for some children we think that they may be helped by having a special breathing mask and ventilator to help them breathe properly at nighttime Does the breathing mask hurt the child or not? No, it doesn’t hurt, but it does feel a bit strange It feels a bit odd, because going to sleep with a mask on your face is a bit odd This is the mask itself, which the child puts on their face and there’s lots of different types of masks which we fit to make sure it’s the right size for the child and which one they find most comfortable The mask has air blowing into it and it blows in through this long tubing which goes round and goes all the way there, to the ventilator Most children cope well with just coming to try and start on the mask ventilator but some children find it more
difficult and for those children we will often ask our psychologist Louise to
have a chat with the child and their family Would you like to meet Louise? Yes, please Ok Hi Sophie, I’m Louise, I’m a clinical
psychologist, I work with the respiratory team and I help them when young people need
to wear their NIV mask, their breathing mask Do all children worry or is it just small children? I think all children worry when they’re trying new things So sometimes we can come up with ideas to help them like using pictures, social stories, reward charts and that’s for young children, older children and also children with learning difficulties or disabilities It can sometimes behelpful if I come and see you getting your mask fitted Do you want me to come along? Yes, please I’ll introduce myself, I’m Andrew one of the sleep team team and I’m going to take you through how we pick a mask and use the machine to help your breathing overnight So first of all, before we can do anything, I need to ask you what do you do when you sleep Do you, breathe through your nose at nighttime or is it through your mouth? I’m not sure What about mum, what would she normally do? I think you might breath more through your mouth Through your mouth, right that’s important because if we put a mask on and it’s blowing air up your nose and your mouth is open the air comes straight back out your mouth and doesn’t get down to your lungs and help with your breathing So, the plan is we’ll try and find a mask that does your nose and your mouth together to allows us to get that So, I need to size your nose and mouth first of all to make sure I get the right mask So if it’s okay I’m going to pop this next to your face It just tells me which size to pick So we just line it up here that should be an extra small, that’s fine, I got one of them here with me Let’s have a look So, what we’re going to do now, is try and put this mask on and see what it feels like with the machine blowing in the mask Don’t worry if it feels a wee bit strange most of the boys and girls think it’s a bit odd to begin with and we normally practice to get the hang of it Okay So I’ll pop it on your nose first and don’t be surprised if it feels a wee bit funny to begin with Okay Here we go I just need you to gently breathe in and out So blow back out, that’s it good In and out, not too fast, that’s excellent You’re getting the hang of it Good Ok, don’t worry about that, that sometimes happens What is probably happening there is that I’m not holding it tight enough because I’m always a bit cautious, so that noise is just the mask flapping What did you think of that? It felt weird, but it got better as it went along So it’s quite hard to start with, isn’t it Yeah Okay, so why don’t we get the head gear then and we can attach that to your head as well and that way I’m not holding it Alright, when I press go remember it’s going to blow a wee bit to start with and feel a bit strange Here we go Remember, this time try not to do such big breaths just little breaths I know the temptation is to take huge breaths but just little ones Well done Sophie, this is excellent Just a wee bit slower if you can You’re going really fast That’s it, in and out Ok mum, so what we’re trying to do now is to try her to wear it for a wee bit longer Because obviously having it on and off and on and off is not quite the same as
having it on for the whole night So even if it’s for 10-15 minutes of playing to get her used to that sensation that would be helpful and then what we’ll do, is work out what we can do for the night So hopefully she would fall asleep and if she does that might be all she can cope with or it might be that we can start to tweak
the pressure to the one we think will be beneficial for her So what do you do if a child finds it really difficult to wear the mask at night? Good question, it’s not uncommon for them to find it tricky, particularly at the start just because it’s a strange sensation and trying to wear it all night Obviously, you are very keen for them as the parent to wear it What we found is if there’s an invested parent, then we do much better So if you’re trying to make sure this process works then have much more chance of being successful So just keep encouraging and keep
emphasising that they’ll feel the benefit and hopefully we start to see more and more time overnight on the machine Okay Thank you very much No problem Okay Sophie, do you have any other questions? No and thank you for showing me how to use the breathing mask

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