PAP Desensitization Clinic

Helping Children Succeed with PAP Therapy 

The PAP Desensitization Clinic at Lurie Children's provides specialized support for children and adolescents who are having difficulty adjusting to positive airway pressure (PAP) therapy, including continuous positive airway pressure (CPAP) and bilevel therapy. 

Our goal is to help children feel comfortable, confident and successful using PAP therapy to improve their breathing, sleep quality, overall health and quality of life. 

The clinic is available at both Lurie Children's Main Hospital in Chicago and Lurie Children's Outpatient Center in Schaumburg. 

Our Multidisciplinary Approach 

The multidisciplinary PAP Desensitization Clinic is led by nurse practitioners Maria Gonzalez, APRN, in Schaumburg; Tiffany St. James, APRN, at Lurie Children’s Main Hospital; and Dr. Allison Clarke, a pediatric psychologist and behavioral sleep medicine specialist. The team collaborates with other specialties involved in each patient’s individual care. This may include Sleep Medicine, Pulmonary, Otolaryngology, Neurology, Cardiology, Plastic & Reconstructive Surgery, Pediatric Bariatric Surgery Program, and the Muscular Dystrophy Association (MDA) Clinic, among others. 

This innovative program addresses the many factors that can affect PAP therapy success, including: 

• Medical and respiratory concerns 
• Equipment and mask-related challenges 
• Anxiety and sensory sensitivities 
• Behavioral and routine-related barriers 
• Family education and support 

Through regular follow-up visits, early troubleshooting and individualized care plans, our team helps children gradually build comfort with PAP therapy and improve treatment adherence. 

What Is PAP Desensitization?

PAP desensitization is a gradual, step-by-step process that helps children become more comfortable using positive airway pressure (PAP) therapy, including CPAP and bilevel therapy. 
Rather than expecting a child to immediately wear PAP throughout the night, we work at a pace that feels manageable for them. Over time, children develop confidence and comfort with the equipment, making it easier to use PAP consistently during sleep. 

Why Is PAP Desensitization Important? 

Adherence to PAP therapy can help: 

• Improve sleep quality and overall quality of life 
• Optimize lung health 
• Prevent hospitalizations

Who Can Benefit From This Clinic? 

This clinic is designed for children and adolescents who: 

• Have been prescribed PAP therapy but are struggling to start treatment 
• Have difficulty tolerating or consistently using PAP 
• Previously used PAP successfully but are now experiencing new challenges 

Children with the following conditions or concerns may particularly benefit:

• Anxiety
• Sensory sensitivities
• Autism spectrum disorder
• Down syndrome
• Neuromuscular disorders
• Developmental differences
• Other medical or behavioral challenges that interfere with PAP use

What If My Child Refuses to Wear Their PAP Mask?

Many children initially struggle with PAP therapy, and that's okay. 

Our team works to identify what is making PAP difficult and starts at a level that your child can comfortably tolerate. 

For some children, the first goal may simply be: 

• Touching the mask 
• Holding the mask 
• Allowing the mask near their face 
• Wearing the mask briefly while awake 

Families receive individualized home practice goals designed to create positive experiences and build success gradually over time. 

What Happens During a PAP Desensitization Visit? 

During your visit, our team will: 

Review PAP Therapy 

We evaluate: 

• PAP prescription and settings 
• Current PAP usage 
• Mask fit and comfort 
• Air leaks 
• Equipment-related concerns 
• Other medical factors that may affect therapy 

Identify Barriers to Success 

We assess factors that may interfere with PAP use, including: 

• Anxiety or fear 
• Sensory sensitivities 
• Bedtime routines 
• Behavioral challenges 
• Family concerns 

Practice PAP Skills

Children have opportunities to practice with their PAP equipment in a supportive environment at a pace that is appropriate for them. 

Explore Equipment Options 

When needed, we may: 

• Recommend equipment settings 
• Recommend comfort strategies 
• Try different mask styles and sizes 

Create a Personalized Plan 

Families leave each visit with: 

• Individualized home desensitization goals 
• Practical strategies to use at home 
• Clear next steps before the next appointment

Common PAP Challenges We Can Help Address 

Our clinic supports families experiencing: 

• Refusal to wear the mask or headgear 
• Sensitivity to something touching the face 
• Anxiety, fear, or claustrophobia 
• Difficulty tolerating airflow or pressure 
• Removing the mask after falling asleep 
• Mask fit, leak, or comfort issues 
• Challenges incorporating PAP into bedtime routines 
• Inconsistent PAP use 
• Difficulty progressing from daytime practice to overnight use

How Long Does the Process Take? 

Every child progresses differently. 

Some children make significant progress after only a few visits, while others benefit from additional support over a longer period. Our team works closely with families to develop realistic goals and celebrate progress at each step. 

There is no single timeline for success, and we tailor care to each child's unique needs. 

Family-Centered Care 

We recognize that successful PAP therapy involves the whole family. Our clinic emphasizes: 

• Education and coaching 
• Ongoing support 
• Individualized treatment plans 
• Collaborative problem-solving 
• Positive reinforcement strategies 

We partner with families every step of the way to help children build healthy sleep and breathing habits. 

Referrals and Appointments 

Currently, patients are referred to the PAP Desensitization Clinic by their Sleep Medicine or Pulmonary Medicine provider. 

If you believe your child may benefit from PAP desensitization services, please speak with your child's sleep medicine or pulmonary care team to discuss a referral.