For sure if you use small tidal volumes and the mouth open won't help like bubble CPAP you should close the mouth and apply the ventilation .Also the size of the nasal prong or canula is very important to achieve good oscillation.
Actually in my experience use of mild sedation in CPAP patient unavoidable but cautious use of short half life and low dose narcotics like fentanil or midazolam is advised.
dr Ghodstehrani senior specialist neonatologist
Iranian hospital Dubai
In my unit I use daily FFP for at least three days, frequent doses of IT epinephrine and if plt more than 50000 and not severe hemorrhage a full course of Ibuprofen.
dr Ghodstehrani senior specialist neonatologist Iranian hospital Dubai