What is the cause of shortness of breath in children? Shortness of breath in children, especially at night, can be a worrying experience for parents. While sometimes this problem can be caused by a simple cold, it can also be a sign of a more serious underlying condition that requires medical attention. Understanding the common causes of shortness of breath at night in children and knowing when to see a doctor is vital to maintaining their health. This article examines the most important causes of shortness of breath in children. Why does shortness of breath in children occur more at night? Several factors cause breathing problems in children to worsen at night: ### Sleeping position In the lying position, secretions from the nose and throat can easily move to the lungs and cause irritation and partial obstruction of the airways. ### Room temperature and humidity Dry or very cold air can irritate the respiratory tract and aggravate coughing and shortness of breath. ### Increase the activity of the parasympathetic system During sleep, the parasympathetic nervous system becomes more active, which can lead to narrowing of the airways in some diseases (such as asthma). ### Exposure to allergens Some allergens, such as dust mites that accumulate in the bed, can cause irritation and allergic reactions during the night. Common causes of nocturnal dyspnea in children ### Asthma Asthma is the most common cause of shortness of breath at night in children. In asthma, the airways become inflamed and narrow. Asthma symptoms often worsen at night because the airways tend to constrict more during sleep, and exposure to bedroom allergens (such as dust mites) can exacerbate symptoms. Symptoms: chronic cough, wheezing (whistling sound when exhaling), shortness of breath and a feeling of pressure in the chest that increases at night and early morning. ### Upper respiratory tract infections (colds and flu) Colds and flu cause stuffy nose, runny nose and cough. When the child lies down, secretions from the nose and throat fall to the back of the throat and can irritate the airways and aggravate coughing and shortness of breath at night. Symptoms: runny nose, sneezing, cough, fever, sore throat. ### Khorosk Chrush is a viral infection that causes inflammation of the larynx and trachea. The disease is characterized by a barking cough, and symptoms often worsen at night due to increased inflammation and dry air. Symptoms: barking cough, snoring sound in the tail, mild fever, hoarseness. ### Bronchiolitis Bronchiolitis is a common viral infection of the lower respiratory tract that is mostly seen in infants and young children under 2 years of age. This disease causes inflammation and swelling of the bronchioles (the smallest airways in the lungs). Symptoms: wheezing, rapid breathing, cough, nasal congestion, mild fever. Symptoms often worsen at night and while lying down. ### Obstructive sleep apnea In this condition, the child's breathing stops frequently, partially or completely during sleep. This is often due to the large tonsils and adenoids (third tonsils) that block the airways during sleep. Obesity is also an important risk factor. Symptoms: loud and irregular snoring, pauses in breathing, sudden gasping for air, excessive sweating during sleep, restlessness during sleep, and tiredness or sleepiness during the day. ### Gastroesophageal reflux Backflow of stomach acid into the esophagus and sometimes into the airways, especially when lying down, can cause irritation and coughing or shortness of breath. Symptoms: chronic cough, wheezing, indigestion, heartburn (in older children), vomiting. ### Allergens Exposure to allergens (such as dust mites, pet dander, pollen, or mold) in the home environment, especially in the bedroom, can cause allergic reactions that lead to stuffy nose, runny nose, cough, and shortness of breath. Symptoms: sneezing, runny nose, itchy eyes and nose, dry cough, wheezing (in case of allergic asthma). ### Foreign bodies in airways If the child has inhaled a small object, it may cause partial or complete obstruction of the airways, which can aggravate the symptoms of shortness of breath in the lying position. Symptoms: sudden and severe cough, suffocation, unilateral wheezing (in one lung), difficult breathing. This is an emergency situation. ### Anxiety and panic attacks In older children and adolescents, stress and anxiety can lead to nervous dyspnea, which may worsen at night when the mind is preoccupied with thoughts. Symptoms: rapid and shallow breathing, feeling of suffocation, dizziness, palpitations, feeling weak. When is shortness of breath in children dangerous? If your child shows any of the following symptoms in addition to shortness of breath at night, you should see a doctor or emergency room immediately: - Bruising of lips, tongue or nails - Severe panting or breathing very fast and consecutively. - Severe depression of the chest - Up and down nostrils with each breath - Loud snoring sound when breathing or grunting - Inability to speak, eat or breastfeed due to shortness of breath - Severe lethargy, unusual sleepiness or unresponsiveness to stimuli - High fever with severe shortness of breath - Wheezing or cough that does not improve with prescription drugs (if available). Basic measures at home In case of mild shortness of breath and if there are no warning signs: - Keeping the baby's head up: by placing an extra pillow under the baby's head (for older children) or raising the head of the bed a little. - Use of cold fumigation: A cold fumigation device can increase air humidity and help loosen secretions and reduce airway irritation. - Drinking warm liquids: For older children, warm liquids such as tea or warm water with honey (for over a year) can help soothe the throat and loosen phlegm. - Avoiding stimuli: keeping the child away from cigarette smoke, strong sprays and chemicals. #### Summary Shortness of breath in children can have various causes, from viral infections to chronic diseases such as asthma or sleep apnea. Parents should be alert and able to differentiate between mild symptoms and warning signs. If you see any alarming symptoms, especially warning signs, it is necessary to see a doctor immediately for timely diagnosis and treatment and to prevent serious complications. To visit Dr. Mehdi Afshari's office, call 02166602506 or make an appointment online.