Sleep-disordered breathing is a type of sleep disorder. Kids wake up during the night because something disrupts their normal breathing during sleep. It results in poor, disturbed sleep.

Symptoms of sleep-disordered breathing during sleep:

• Loud snoring
• Gasping, choking or snorting sounds
• Pauses in breathing (apnea)
• Restless sleep
• Mouth breathing
• Frequent waking or night sweats

Symptoms of sleep-disordered breathing during the day:

• Daytime fatigue
• Headaches
• Difficulty waking up in the morning
• Dry mouth upon waking

Ongoing disturbed breathing during sleep can affect health, development, behavior and school performance.

These can include:

• Trouble focusing
• Mood swings
• Weight gain
• Hyperactivity
• Slow growth or failure to thrive
• Bedwetting
• High blood pressure or heart problems (in severe cases)

Children's Wisconsin treats all sleep-related breathing issues.

Obstructive sleep apnea

Obstructive sleep apnea (OSA) occurs when a child briefly stops breathing while sleeping. The pause in breathing usually occurs because something is blocking the airway.

Risk factors include:

• Enlarged tonsils or adenoids
• Obesity
• Genetic conditions, including Down syndrome or Pierre Robin sequence. These can cause structural and muscle-related issues that block the airway.

Central sleep apnea

Central sleep apnea (CSA) is when the brain does not send the proper signals to the breathing muscles. A child may stop and start breathing over and over during sleep. It is not due to a blocked airway.

Hypoventilation and hypoxemia

Hypoventilation is when a child's breathing is too shallow or slow during sleep. It leads to low oxygen levels (hypoxemia) and high carbon dioxide levels.

Hypoventilation can be due to:

• Weakness from a disease like muscular dystrophy
• Obesity hypoventilation syndrome
• Diseases that stop the lungs from expanding as fully as they should
• A rare condition called congenital central hypoventilation syndrome

Our sleep experts will help find out if your child has a sleep disorder and suggest the best treatment option. Sometimes, they may only need lifestyle changes to sleep better. Other times, they may need special tests in our Sleep Center to find out what's wrong.

Medicines

Asthma medicines or nasal steroids can help some kids with nasal congestion. Swollen tissues in the nose and throat may play a role in mild OSA. These can improve airflow, allowing your child to breathe easier during sleep.

Tonsils and adenoid removal

Enlarged tonsils and adenoids are the most common airway blockages in kids with OSA. Your doctor will inspect your child's throat to see if these tissues block the airway. In young kids, the most common treatment is surgery (adenotonsillectomy) to remove them.

The surgeon removes the tonsils and adenoids through the mouth while your child is under general anesthesia. Your child can go home the same day, but recovery lasts a week or more. Your child will experience a sore throat and difficulty swallowing as they heal.

In many cases, the surgery resolves the OSA. In a few kids, it doesn't. This condition is obstructive sleep apnea persisting after adenotonsillectomy.

Weight loss

Weight loss can improve OSA or hypoventilation from obesity. Excess weight around the neck and upper airway narrows the airway and causes breathing issues. In this case, losing weight may help your child breathe better and sleep better.

Devices

If surgery doesn't work or isn't an option (like in CSA or obesity), kids may need a sleeping mask. Called a positive airway pressure device, it gently pushes air into their lungs while asleep, keeping the airway open.

Options include:

Kids with OSA who don't get better with surgery may need a continuous positive airway pressure (CPAP) machine.

Kids with CSA, who don't get better with surgery, or who can't tolerate CPAP, may need a bilevel positive airway pressure (BiPAP) machine. It pushes air more when breathing in.

An oral appliance may help some older children or teenagers with mild OSA. It helps reposition the lower jaw during sleep to keep the airway open. These look like a mouthguard or retainer that your child wears during sleep. They may be a good option for kids who can't tolerate CPAP and aren't good candidates for surgery.

The Children's Wisconsin Sleep Center helps kids and teens with sleep problems get the care and treatment they need.

Wisconsin's only: Children's Wisconsin offers the only sleep center in the state dedicated solely to caring for kids and teens.

Accredited center: Our CPAP Program has American Academy of Sleep Medicine accreditation. That means our program meets its rigorous standards for sleep disorder care in children and teens. We give kids high-quality care tailored to their needs.

Award-winning: U.S. News & World Report ranked pulmonary care at Children's Wisconsin among the best in the nation. Our CPAP Program and Sleep Center are part of our Pulmonary Medicine Program.

Wrap-around care: We care for kids with sleep problems at home, in the clinic and the hospital.

Our Sleep Center includes a sleep clinic and a sleep lab. For questions or to plan a visit, call us at (877) 607-5280.

Before

You may need a referral from your child's primary care doctor. Once that's in place, you'll schedule a clinic visit.

Before the clinic visit, we may ask you to complete forms about:

• Your child's sleep habits
• Their health history
• Any concerns

During

During your child's clinic visit, they'll meet with a sleep expert. You'll discuss sleep issues, behaviors, and symptoms. They may observe or examine your child and ask detailed questions to understand the problem.

After

If you have a clinic visit, the doctor may provide initial findings or next steps right away. They may recommend a sleep study or other tests to understand your child's sleep habits.