Is Your Child Wheezing in Their Sleep?

The Possible Reasons Why Your Child Could be Wheezing in Their Sleep

Any parent worries when their child is sick, but the anxiety amplifies during the night hours. Parents contact on-call physicians or nurses during the night most commonly for fevers, but the second most common reason is breathing problems, such as wheezing.

Children often experience respiratory disorders that cause coughing. While some conditions are characterized by labored breathing or wheezing, others are accompanied by other symptoms. Understand how to identify the symptoms and causes of wheezing, and how best to determine treatment options.

What is Wheezing?

Wheezing is characterized as a whistling sound from the chest during exhale. The flow of air through the tubes inside the lungs are partially blocked, and is commonly caused by a combination of three things inside the lungs:

  • Tiny muscles around the airways tighten
  • The walls of the airways become swollen
  • There is more mucus inside the airways

While it is a classic sign of asthma, there are also other underlying causes of wheezing in children. In young children, wheezing is most commonly associated to viral infections.

If the diagnosis is viral-associated or viral-induced, symptoms may not respond to medications used for asthma. However, in children with asthma, most acute wheezing episodes are also caused by viral infection. When a child does not respond to asthma medication, they are less likely to have asthma and may require medical attention depending on severity.

Children with asthma have ongoing changes in their lungs that can trigger wheezing and breathing disorders. These changes include colds (viral respiratory infections); physical activity; cold air; or house dust mites, pollen, or cat fur.

In most children, wheezing symptoms are intermittent but some children can have chronic symptoms. This is why it is important for children with asthma to have regular appointments with their doctor to make sure their asthma is under control.  If symptoms persist, consult your doctor to discuss further treatment options.

What are the Causes?

A number of conditions that affect the respiratory system while asleep can cause wheezing. Colds and allergies can lead to coughing and wheezing. Exposing your child to cigarette smoke in your home or car can increase his risk of developing respiratory problems. Other possible causes of wheezing include: allergies, anaphylaxis, asthma, bronchiolitis, bronchiectasis, bronchitis, emphysema, pneumonia, respiratory syncytial virus (RSV), respiratory tract infection, and sleep apnea.

Warning Signs

While some cases of wheezing are minor, other cases require medical attention. If it doesn’t go away or keeps coming back, asthma could be the underlying cause. Situations that require immediate attention include rapid or irregular breathing, skin that appears blue or pale, unusual disorders, a fever above 102 Fahrenheit. These symptoms can signal the presence of pneumonia, a condition requiring immediate medical treatment.

Treatment & Prevention

Treatment options vary by cause and severity.

If wheezing is caused by asthma, your doctor may recommend the following treatment options to reduce inflammation and open the airways:

  • A fast-acting bronchodilator inhaler to dilate constricted airways when you have respiratory symptoms (i.e. Preventil HFA, Ventolin HFA, Xopenex)
  • An inhaled corticosteroid (i.e. Qvar, Pulmicort, Alevsco, Aesospan, Flovent, Asmanex)
  • A long-acting bronchodilator/corticosteroid combination (i.e. Symbicort, Advair)
  • An asthma controller pill to reduce airway inflammation (i.e. Singulair, Accolate)
  • A non-sedating antihistamine pill (Zyrtec, Allegra, Claritin, Rhinocort, Flonase, Nosonex)

If wheezing is caused by acute bronchitis, your doctor may recommend some of the following:

  • A bronchodilator to help ease the wheezing as the infection clears (i.e. Proventil HFA, Ventolin HFA, Xopenex)
  • An antibiotic is not usually needed unless you have an underlying chronic lung problem or your doctor suspects a bacterial infection is present

If your child continues to have difficulty breathing and is wheezing, seek immediate medical attention. The medical team may administer any of the following:

  • A shot of epinephrine to open clogged respiratory passages
  • Oxygen
  • A corticosteroid (i.e. methylprednisolone or prednisone)
  • Frequent or continuous nebulizer treatments
  • A mechanical ventilator to help you breathe

Prevention and At-Home Measures

To ease you child’s wheezing (whether they’re asleep or awake), here are a few tips:

  • Moisturize the air to help relieve mild wheezing. Use a humidifier, have your child take a steamy shower or sit in the bathroom with the door closed while running a hot shower.
  • Drink warm fluids to help relieve mild wheezing.
  • If anyone in the house smokes, make sure they avoid doing it around your child – the best solution is to ensure any smokers do so outside.
  • Take prescribed medications for treatment and prevention. Follow the doctor’s instructions.

If you’re concerned by your child’s wheezing while they’re asleep, be sure to get in contact with sleep and asthma specialist Dr. Shukla today.

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