Pediatric Pulmonology and Sleep Health

Complex conditions may affect more than one organ system at the same time — such as the lungs and heart, or the lungs and muscles. Our pediatric pulmonologists work alongside other specialists to care for complex conditions that affect your child’s lungs, airways, or breathing, such as:

Muscular weakness syndromes

Your child depends on multiple muscle groups to power their breathing, including the diaphragm, chest muscles, and abdominals. If your child has a condition that causes skeletal muscle weakness (such as muscular dystrophy, spinal muscular atrophy, or nemaline myopathy), it can make it more difficult for them to breathe or get enough oxygen.

Pulmonary hypertension

High blood pressure in lung arteries forces the heart to work harder at pumping blood through them. In addition to respiratory problems like shortness of breath, this also strains the heart and can damage it over time.

These lung and airway problems are present at or shortly after birth with symptoms that are noticeable within the first moments to first few years of life. Examples include:

Alpha-1 antitrypsin deficiency

A mutated gene prevents the body from producing enough of a specific protein that helps protect the lungs. In addition to respiratory systems like coughing, wheezing, and shortness of breath, this condition can eventually lead to lung and liver damage.

Bronchomalacia and tracheomalacia

Weak and underdeveloped walls of the windpipe (in the case of tracheomalacia), the bronchial tubes that connect to the lungs (bronchomalacia), or both may become compressed or obstructed.

Bronchopulmonary dysplasia (BPD)

This condition, also known as chronic lung disease of infancy, can affect preterm babies who require oxygen therapy or mechanical ventilation as newborns.

Congenital lung malformations

This refers to lungs or airways that do not fully develop or develop improperly in the womb. Examples include blocked airways, smaller-than-normal lungs, and other problems.

Primary ciliary dyskinesia

This genetic condition prevents the tiny, hairlike structures in the airways (cilia) from being able to sweep out mucus and other debris efficiently. It can lead to more frequent respiratory infections, as well as symptoms like persistent coughing and wheezing.

These conditions cause inflammation, narrowing, or damage to the lower airways (bronchi and bronchioles), air sacs (alveoli), and other tissues of the lungs. They include:

Asthma

This condition can trigger narrowing of the airways of the lungs, which can lead to episodes of breathing difficulty (including coughing, wheezing, chest tightness, and shortness of breath).

Bronchiectasis

Lung airways become widened, which keeps them from clearing out mucus efficiently. Over time, the accumulation of mucus can further damage the lungs and increase the risk of chronic infections.

Bronchiolitis

Infection and inflammation of the bronchioles, which is the dense network of small airways that spread out through the lungs and attach directly to the air sacs (alveoli) that exchange oxygen and carbon dioxide within the bloodstream.

Bronchitis

Infection and inflammation of the two main airways that lead directly to each lung (bronchial tubes).

Hypersensitivity pneumonitis

An allergic reaction that causes inflammation in the air sacs (alveoli) and the tissues that surround and support them. It is considered a type of interstitial lung disease (ILD) that affects both children and adults.

Interstitial lung diseases (ILDs)

This is a group of related conditions that cause inflammation and scarring (pulmonary fibrosis) in the lung tissue that surrounds the air sacs (alveoli). The scar tissue makes it more difficult for the lungs to fill with air and get enough oxygen into the bloodstream. Some forms of ILDs are known as childhood ILDs (chILDs) because they mostly develop in children, have very different root causes than adult-onset ILDs, and require different treatments.

Recurrent pneumonia

Pneumonia refers to a group of lung infections that cause fluid buildup and swelling in the air sacs of the lungs. Symptoms vary depending on severity, but typically last more than a week and can include cold-like or flu-like symptoms, breathing difficulties, very high fever, chest pain, vomiting, or confusion. Recurrent episodes of pneumonia (more than one in a year) could be a sign of a more serious underlying health problem.

Many sleep disorders are linked with respiratory problems. A pediatric pulmonologist or sleep health specialist may be part of your child’s care team for conditions such as:

Idiopathic hypersomnia

Children with this condition are difficult to wake and excessively sleepy during the daytime, even though they get plenty of sleep at night time.

Insomnia

General term for difficulty falling or staying asleep, especially when that lack of quality sleep causes daytime problems like fatigue, inattention, irritability, or other cognitive or behavioral issues.

Narcolepsy

Children with this condition feel excessively tired during the day and may fall asleep without warning, even during conversations or activities. Most also sleep poorly at night and may experience periodic losses of muscle control while still awake (cataplexy) for up to a few minutes at a time.

Nocturnal hypoxia

This occurs when the oxygen in the bloodstream reaches dangerously low levels during sleep, often due to sleep apnea or other sleep or breathing disorders. It can cause serious health issues if left untreated.

Obstructive hypoventilation syndrome

This condition causes chronically slow or shallow breathing in some children who are obese. It can prevent them from getting enough oxygen in their bloodstream or removing enough carbon dioxide. It often occurs alongside sleep apnea and can cause life-threatening complications if not treated.

Periodic breathing in infants

When sleeping, babies with this condition stop breathing for up to 10 seconds, then follow up with several quick, short breaths. The cycle may repeat several times in a row, then return to a natural rhythm. Treatment may be necessary if breathing pauses last longer than 10 seconds or continue after six months of age, or if there are signs of lack of oxygen (such as blue lips or difficulty waking).

Periodic limb movements of sleep

Involuntary twitching or jerking of arms or legs during sleep, usually every 20 to 40 seconds. While your child may be unaware that they are doing this, it can still wake them throughout the night or reduce their quality of sleep.

Sleep apnea

Repetitive stopping and starting of breathing during sleep. This is often caused by relaxed throat muscles physically blocking the airway (obstructive sleep apnea), but other causes are possible, including how the brain controls breathing rhythm (central sleep apnea).

The airways are the network of passageways that move air in and out of the lungs. The upper airways specifically include those located within the head and neck — the nasal cavities, sinuses, throat (pharynx), and voice box (larynx). Conditions we treat include:

Chronic rhinosinusitis (chronic sinusitis)

Symptoms of this condition include runny nose, congestion, difficulty breathing, and facial swelling or tenderness that lasts 12 weeks or more due to chronic swelling of sinuses in the nose and face.

Croup

Children with this viral infection of the upper airways often have a persistent cough that sounds like a seal barking. Other potential symptoms include fever, hoarseness, and difficulty breathing.

Vocal cord disorders

A number of conditions can affect the vocal folds of the larynx, resulting in voice changes (such as raspiness or breathiness) or difficulty with breathing or swallowing. Examples include laryngitis and other infections, tumors or polyps, and vocal fold paralysis.