Pediatric Sleep Disordered Breathing

When Your Child Can’t Breathe, They Can’t Sleep
People often say children “look like angels when they’re sleeping.” The innocence of true rest in a child’s deep sleep is unequaled in the world. Unfortunately, some children don’t get to enjoy this level of sleep because they can’t breathe during sleep. Pediatric sleep-disordered breathing (SDB), also known as sleep related breathing disorders (SRBD), can turn a child’s night from a peaceful dream into a fight for breath. This fight can leave them exhausted during the day with no energy for learning or play. In the long term, this fight can also cause major disruptions to their health and growth.
Fortunately, sleep-disordered breathing is highly manageable. There are many manageable options that can give your children the rest they need to grow and enjoy their childhood. If you think your child is suffering from sleep-disordered breathing, please contact an ASAP Pathway dentist to get them screened for breathing problems.
What Is Pediatric Sleep Disordered Breathing?
Pediatric sleep-disordered breathing describes a condition where a child is unable to breathe easily at night. This prevents them from getting the oxygen they need to function. As we’ll talk about more later, the severity of the disruption can range from a “cute” snoring sound to a life-threatening stoppage of breath.
More than a quarter of all children may suffer from some type of SDB or SRBD, with up to 5% having the severe form, sleep apnea.
The Types of Pediatric Sleep Disordered Breathing
Although all types of pediatric sleep-disordered breathing interfere with a child’s breathing, they have numerous causes and severities. Knowing the types and terms used to describe them can help you talk about your child’s condition with a dentist or physician.
Central Sleep Apnea (CSA)
Central sleep apnea occurs when the part of the brain that is supposed to control breathing doesn’t work properly. It is most common in infants, especially premature babies whose brains may not be fully formed yet. However, brain injuries and certain types of brain malformations can cause this as well.
Obstructive Sleep Disordered Breathing (OSDB)
However, most children have what is known as obstructive sleep-disordered breathing. In this condition, something is obstructing a child’s airway, making it hard, even impossible, for them to breathe.
The source of obstruction can vary. The tongue, enlarged tonsils and/or adenoids, and fat deposits on the neck are common sources of obstruction. Most doctors and dentists talk about OSDB as either snoring or obstructive sleep apnea (OSA), which has dangerous stoppages in breathing.
However, others emphasize that the condition is a continuum, and may identify the following points along the continuum, from least to most severe:
- Snoring
- Upper airway resistance syndrome (UARS)
- Obstructive hypopnea
- OSA
Although many doctors use UARS as an independent diagnosis for adults, most have transitioned to folding the condition into OSA. Some doctors describe obstructive hypopnea as a condition that creates low-oxygen or high carbon dioxide levels in the body without evidence of full obstruction. However, as with UARS, most doctors prefer to describe obstructive hypopnea as part of OSA.

Diagnosing and Managing Pediatric
Sleep Disordered Breathing
Most parents and caregivers begin to suspect pediatric sleep-disordered breathing because of common symptoms, such as:
- Snoring
- Bed-wetting
- Sleep terrors
- Poor school performance
- Low energy
- Learning challenges
- Behavioral problems
- Failure to grow
- Unhealthy weight gain
- “Hyperactivity” including diagnosed ADHD
However, as with sleep apnea among adults, it’s not usually considered enough to identify the symptoms of sleep-disordered breathing. Instead, a child will be diagnosed with a sleep study (polysomnography, sometimes abbreviated PSG).
How do you know if your child would benefit from talking to a doctor or dentist about a sleep study? Our screening quiz can help.
If your child is diagnosed with sleep-disordered breathing, the management options vary depending on the type and severity of the condition. They might include:
- Myofunctional therapy
- Oral appliances
- Orthodontics / orthopedics
- Medication
- CPAP (continuous positive airway pressure)
- Surgery
An ASAP Pathway dentist can talk to you about your options, find a local ASAP Pathway provider.