Noninvasive ventilation (NIV) is widely used in children. Only a few devices are life support ventilators. The pressure support (PSV) mode is the most common used mode for home NIV, while assist-control pressure ventilation (PAC) is usually used in patients with abnormal central drive. Patient-ventilator asynchrony (PVA) is common during NIV and may have different causes, such as unintentional leaks, inadequate settings or misunderstanding of the settings. However, PVA may also be due to issues related to the NIV device, which is less common and is challenging. We report here the cases of 5 children with PVA due to trigger issues with a recent life support device.