Sleep Therapy

Sleep is a major physiological drive. The average child spends almost one-half of his or her life asleep. A newborn will sleep for as much as 16 h a day. Thus, respiratory disorders during sleep are of particular importance during childhood. Although some respiratory disorders, such as sleep apnea, occur only during sleep, virtually all respiratory disorders—including upper airway obstruction, central hypoventilation, and chronic lung disease—are worse during sleep than wakefulness. It is therefore incumbent upon the pulmonologist to understand the effects of sleep upon breathing. Despite this, it is only recently that the medical community has started to scientifically evaluate sleep, and there are still large gaps in our knowledge.

This review will not attempt to provide a comprehensive description of all spects of pediatric sleep-disordered breathing. Rather, it will focus on the differences in these disorders between children and adults, from a developmental perspective. Due to space limitations, disorders limited to infancy, such as apnea of prematurity, apparent life-threatening events, and sudden infant death syndrome, will not be discussed.