Pediatric Sleep Disordered Breathing
Pediatric sleep-disordered breathing (SDB) is a broad term describing breathing difficulties during sleep. It ranges from habitual snoring to obstructive sleep apnea (OSA)—a condition where part or all of the airway becomes blocked repeatedly throughout the night.
When a child’s breathing is disrupted during sleep, the body perceives it as a choking event. This triggers a stress response in the nervous system:
Heart rate increases
Blood pressure rises
Brain arousal occurs, repeatedly disrupting sleep
Oxygen levels drop
This constant interruption prevents the body from entering deep, restorative sleep—the critical phase where the brain consolidates memory, regulates emotions, and supports physical growth.
Sleep Disordered Breathing and ADHD
Many children diagnosed with ADHD may actually have an undiagnosed sleep disorder. Studies show that mild to moderate sleep-disordered breathing can mimic ADHD symptoms, leading to:
Inattention, trouble focusing, and difficulty following directions
Hyperactivity, restlessness, and impulsivity
Irritability, mood swings, and emotional dysregulation
Why does this happen?
Mouth breathing and poor airway function activate the sympathetic "fight-or-flight" nervous system, keeping the body on high alert all night. This prevents deep sleep and reduces oxygen intake, affecting brain function and emotional regulation. Children may wake up feeling exhausted, leading to behavioral struggles and learning difficulties.
Symptoms and Consequences of Pediatric SDB
Pediatric SDB can present in many ways. Symptoms may include:
Loud, habitual snoring – Often interrupted by gasping, choking, or snorting noises
Daytime Sleepiness or Hyperactivity – Inability to concentrate, disruptive behavior, or excessive fidgeting
Bedwetting (Enuresis) – Increased urine production at night due to poor sleep cycles
Difficulty with Learning and Memory – Sleep deprivation weakens cognitive function
Slow Growth and Delayed Development – Poor sleep reduces growth hormone production
Obesity Risk – SDB can increase insulin resistance and contribute to weight gain
Cardiovascular Strain – Repeated oxygen deprivation may elevate blood pressure
What Causes Pediatric SDB?
Several factors can contribute to airway dysfunction in children, including:
Enlarged Tonsils and Adenoids – The most common cause of pediatric airway obstruction
Chronic Mouth Breathing – Often due to allergies, a high/narrow palate, or tongue posture issues
Jaw and Facial Development – Small jaws, recessed chins, or improper tongue function can limit airway space
How is Sleep Apnea Diagnosed?
If you suspect your child may have SDB, a visit to an ENT (ear, nose, and throat specialist) or sleep specialist is crucial. Some cases may require a sleep study (polysomnography, PSG) to measure brain activity, breathing patterns, and oxygen levels overnight. However, even children with mild sleep disturbances—without a full OSA diagnosis—can still experience significant developmental and behavioral consequences.
Every child with ADHD symptoms, frequent snoring, or mouth breathing should be screened for sleep-disordered breathing. Identifying and addressing airway issues early can have profound, life-changing benefits.
How Can Myofunctional Therapy Help?
Myofunctional therapy helps improve airway health by strengthening the muscles of the tongue and orofacial complex. Research shows it can reduce the apnea-hypopnea index (AHI) by approximately 50% in adults and 62% in children.
For children, early intervention is key. Myofunctional therapy can correct poor oral habits—such as mouth breathing and improper tongue posture—that contribute to airway obstruction and sleep-disordered breathing. Strengthening these muscles supports proper craniofacial and palatal development, which may help prevent more severe sleep-related breathing issues, like obstructive sleep apnea (OSA), later in life.
