The Division of Pediatric Pulmonology, Allergy and Sleep Medicine, at the Maria Fareri Children's Hospital, provides comprehensive inpatient and outpatient consultation and management for children suffering from a broad variety of respiratory problems, including allergies, asthma, sleep disturbances of many kinds, and a variety of complex pulmonary disorders. We are the only accredited Cystic Fibrosis Center in the Hudson Valley. The division is dedicated to teaching, research, and patient care.

We have one of the largest such divisions in the nation. Between twenty and thirty new patients a week are referred for evaluation! Our main offices are in the Medical Arts Atrium at Westchester Medical Center, and we have nine outreach offices throughout the Hudson Valley.

Our physicians are dedicated to caring for children with the entire array of respiratory disorders. Our mission is three-fold: patient care, teaching and research. We care for all children with asthma, allergies, cystic fibrosis, recurrent pneumonias, sleep apnea and a wide array of congenital and acquired illnesses that affect the respiratory tract. Our major emphasis is on the diagnosis and management of such disorders.

Your physician may recommend you see a pediatric allergist, pediatric pulmonologist, or pediatric sleep specialist. Or, If you are not certain which subspecialty is appropriate, feel free to call and talk it over with our office staff, which includes Madelint Heydendael, RN, MSN, who is a very experienced nurse who can guide you.

Our division has a very active clinical research program, and we are always performing many clinical studies, particularly focused on asthma and cystic fibrosis. If you are interesting in hearing more about our research projects, feel free to call and speak to Ingrid Gherson, our research coordinator.

In 2008, we opened our Children's Environmental Health Center, the first of its kind in the Hudson Valley. Our center is open for consultations for children with any suspected or known exposures to environmental toxins.

• Asthma Clinical Research Center:
  We are part of a nationwide network of 20 centers supported by the American Lung Association since 1999. Only 5 of these centers, including ours, are pediatric centers. Our goal is to complete large clinical studies that will have real-world, practical and immediate significance to children and adults with asthma.
  
  
• Armond V. Mascia, MD Cystic Fibrosis Center:
  Named after our founder, our CF center cares for patients of all ages, children as well as adults, with Cystic Fibrosis. We are the only CF center in the Hudson Valley, and we are one of only 115 medical centers accredited by the Cystic Fibrosis Foundation, having undergone a very rigorous process that assures excellence in patient care, research and education. Our multidisciplinary team includes physicians, nurses, physical and respiratory therapists, dieticians, social workers, psychologists, psychiatrists and research personnel.
  
  
• Pediatric Pulmonary Function and Exercise Laboratories:
  Westchester Medical Center is home to the only pulmonary function and exercise lab in the Hudson Valley dedicated just to children. We have state-of-the-art equipment designed to measure lung function in children of all ages, including brand new infant testing equipment. 
  
  
• Clinical Allergy Evaluation and Therapy:
  Our pediatric allergists are experts in allergy testing and the diagnosis and management of all allergic conditions.
  
  
• Children's Environmental Health Center of the Hudson Valley
  We offer consultations for children with suspected or known exposures to environmental toxins. In addition, working with the faculty of the School of Public Health of New York Medical College, we offer educational programs dedicated to raising awareness of children, families, schools, communities, and government, of the importance of minimizing exposure of our children to environmental toxins and pollutants. We also perform research, which is vital to understanding the role of the environment in the health of children.
  
  
• Hudson Valley Infant Apnea Center:
  We are experts in the evaluation and management of children with apnea and siblings of victims of SIDS.  As such, we manage all children who require home apnea monitoring.
  
  
• Pediatric Sleep Center:
  We are among the largest referral centers in the entire region for the evaluation of sleep disorders in the pediatric age group. We have experts in several pediatric specialties that are related to the diagnosis and treatment of various sleep disorders.  We also offer comprehensive, state-of-the-art sleep studies for patients of all ages.
  
  
• Pediatric Flexible Bronchoscopy Service:
  Our physicians are experts in performing this often essential diagnostic test, using state of the art bronchoscopes available in appropriate sizes for children of all ages.
  
  
• Fellowship in Pediatric Pulmonology:
  We offer a three-year training program in pediatric pulmonology, one of only about 40 such accredited programs in the United States. This is a rigorous fellowship designed for pediatricians who wish to dedicate their career to academic pediatric pulmonology.
  
  
• Care of the Technology Dependent Child:
  We work with patients who require home mechanical ventilation and other forms of noninvasive ventilation, for both acute and chronic respiratory diseases. We also care for patients with tracheotomies and infants with chronic lung disease of prematurity.

• This overnight diagnostic procedure is noninvasive and painless, with parents or guardians staying with their children throughout the night.
  
  
• The first step is for your child to be seen by a physician - either your own physician or one from the Sleep Center.  After the evaluation of the child's sleep-related symptoms, a polysomnogram (sleep study) is ordered if deemed appropriate.
  
  
• After receiving the physician's referral form, the staff at the Sleep Center will obtain authorization from your insurance company and then contact you to schedule the test.
  
  
• During the sleep study, a technician monitors the child and the equipmen,t while a computerized system digitally records a number of physiological parameters.  This recording will give information with regard to the sleep architecture (sleep stages), the presence of abnormal respiratory events, and whether these events interfere with various normal bodily functions, such as maintaining normal oxygen and carbon dioxide levels, as well as normal sleep.
  
  
• After the study is completed, this data is then evaluated by a sleep physician, who generates a diagnostic sleep report, with recommendations for treatment, which could include surgery (such as removal of the tonsils and adenoids, also know as a T&A), CPAP treatment, weight loss, or medication.

While asleep, does you child…

• Snore? 
• Have pauses in breathing? 
• Gasp for air? 
• Have restless sleep? 
• Sleep in unusual positions (i.e. hyper-extended neck)? 
• Breathe through his/her mouth? 
• Wet the bed?

Also, does your child…

• Have difficulty waking in the morning? 
• Experience daytime sleepiness in school? 
• Have hyperactivity or inattention?
• Show a decrease in school performance or trouble concentrating in class?
• Have morning headaches?
• Have unexplained blood pressure?
• Have poor growth?

If you answered “yes” to even one of these questions, you may want to talk with your family physician or pediatrician about your child's sleep.

It is important to realize that these are just some of the symptoms that could indicate a serious condition known as Obstructive Sleep Apnea Syndrome.

Obstructive Sleep Apnea Syndrome (OSAS)

A condition in which a child has partial or complete airway obstruction during sleep, often associated with snoring and breathing pauses.  This serious condition occurs in 1-3% of otherwise healthy children.  It is most prevalent between ages 2 to 7 years, but can also be seen in infants and adolescents. 


The main risk factors for Obstructive Sleep Apnea Syndrome (OSAS) are:

1. Pediatricians should assess all their patients for the presence of snoring. 
   
   
2. All children that snore on a regular basis (on all or most nights) or have other symptoms of Obstructive Sleep Apnea (OSA) should be evaluated for the presence of OSA. 
   
   
3. An overnight polysomnogram (sleep study) is the best way to accurately differentiate between those children that have OSA and those that have harmless snoring.