Sleep and Home Ventilation Clinic

Jump to information for:

Children, youth and families Healthcare providers

About the Sleep and Home Ventilation Clinic

CHEO’s Sleep and Home Ventilation Clinic is focused on the assessment and management of sleep-related breathing disorders (ex. obstructive sleep apnea), from birth to 18 years, particularly for children with complex medical and/or developmental histories.

We also see children with symptoms suggestive of narcolepsy such as excessive daytime sleepiness/severe difficulty staying awake during the day, despite appropriate amount of sleep at night. Note this is different than fatigue. These children may also be seen by CHEO’s Neurology team.

At this time we do not accept referrals for behavioural sleep and sleep pattern disorders, including:

parasomnias (sleepwalking, sleep-talking, night terrors, etc.)

insomnia (sleep-onset/difficulty falling asleep and/or sleep maintenance/difficulty staying asleep and frequent awakenings.)

delayed sleep phase disorder (difficulty falling asleep until late at night, resulting in sleeping late in the morning. This is common among teens.)

For information that may be helpful to understand and manage these sleep problems, please see our Sleep Resources page.

For more information about CHEO’s Sleep Laboratory and sleep studies, visit CHEO’s Sleep Lab page.

About our team

Our team includes 3 Physicians, 2 Nurse Practitioners, and Respiratory Therapists with the Pulmonary Function Laboratory as well as the Home Ventilation Team. We have access to other disciplines as needed, including Asthma Educator/Advanced Practice Nurse, Social Worker, etc. We also work with other teams that provide support to our patients, including the Neurodevelopmental Health Team and the Autism Program.

Information for children, youth and families

Before your appointment

Please sign up for a MyChart account, prior to your first visit.

Our scheduling team will contact you by phone to schedule an appointment.

Missed Appointments & Late Cancellations
CHEO is committed to providing timely care for children, youth, and families. If this is your first appointment in a clinic or department and you miss two appointments without giving at least 48 hours’ notice, your referral will be returned to the care provider who submitted it. They can then follow up with you to confirm whether you still need or wish to proceed with the referral.

We understand life happens and unforeseen events come up. Please notify us as early as possible by calling 613-737-7600 x2222 — ideally at least 48 hours in advance — if you need to cancel or reschedule. This helps us offer the appointment to another family and keep wait times as short as possible. A cancellation 48 hours or more in advance will not count as a missed appointment.

Please try to take a video of your child’s symptoms of concern (ex. snoring, gasping) and bring this to your appointment.

Patients should avoid, if possible, using the following puffers the day of their appointment:

salbutamol (Ventolin – light blue inhaler) for 4 hours prior

terbutaline (Bricanyl – blue bottom inhaler)

fluticasone/salmeterol (Advair – purple inhaler) for 12 hours prior

mometasone/formoterol (Zenhale – dark blue inhaler) for 12 hours prior

budesonide/formoterol (Symbicort – red bottom inhaler) for 12 hours prior

If your child has had X-rays or a CT scan of the chest done in a non-hospital X-ray lab in Ontario, anywhere in Quebec, or elsewhere, please arrange to get a CD with the images (or online access to the images) to bring to the appointment. A written description of the X-ray's findings is not enough. If your child has seen specialists outside CHEO, please bring a copy of these reports with you. If your child has been hospitalized or visited emergency departments in Quebec or elsewhere outside Ontario, please bring copies of all discharge summaries or reports with you, if possible.

If your child has difficulty falling or staying asleep, please see our Sleep Resources page and implement healthy sleep hygiene strategies, prior to your appointment.

If your child has autism, please attend the Foundational Family Services Sleep Solutions Workshop prior to your appointment.

What to expect during your appointment

We are located in Clinic C-9 on the main floor.

Please plan to arrive 10-15 minutes prior to your scheduled appointment time in case there are delays with parking or finding the clinic and to complete any required paperwork that may be required in advance of your visit.

If your child is on medications and/or inhaler devices (such as an Aerochamber) or other technologies (such as a BiPAP or CPAP machine, a suction machine or oxygen saturation monitor) please bring all of these with you. Remember to empty the water reservoir if applicable.

First, vital signs will be taken by a nurse. If your child is 6 years of age or older and can cooperate, they may have a breathing (pulmonary function) test. Then you will be seen by a physician and/or a nurse practitioner.

In general, you should expect to be here for 60-90mins for a new patient appointment, and 45-60mins for a follow-up appointment. Given our area of practice, urgent situations may arise unexpectedly. We appreciate your patience should we need to spend extra time with a patient ahead of you.

We are a teaching hospital affiliated with the University of Ottawa. As part of our commitment to the education of our future health care providers, learners of various levels and disciplines (ex. nursing students, medical students, medical residents, etc.) may be involved in your care.

If your child needs more complex testing, such as a sleep study or exercise test, these will be booked separately.

After your appointment

A clinic team member will follow-up with you regarding the results of any testing ordered. This may be via MyChart message if you have registered, phone call, or we may arrange a follow-up visit.

Frequently asked questions

How can I make an appointment?

All patients must be referred by a Physician or Nurse Practitioner. After a referral is received, we will notify the referring Physician or Nurse Practitioner whether the referral has been accepted or denied, and if accepted we will provide an estimated/ideal wait time. The actual wait time, however, will vary based on demand and urgency. Once we have an appointment spot to offer, our Scheduling Team will reach you by phone to schedule an appointment.

Who should I contact if I am worried or have questions?

For any emergency, call 911. This includes emergencies involving your child’s Sleep-related concerns.

For patients who are waiting for their first visit with the Sleep Clinic: Please call your family doctor, pediatrician or visit your nearest walk-in clinic for everything else.

For patients who are being followed by the Sleep and Home Ventilation Clinic: For patients who have seen a CHEO Sleep Provider, call the Respirology Clinic Nurse, or send a direct message to them through MyChart. This is not for urgent calls. Our nurses are here to give support, education and will work to coordinate your child’s care. It may take 3-5 days for us to get back to you (and sometimes longer during holidays). We will return the most serious calls first. Please avoid leaving multiple messages for the same issue.

How long will the wait for service be?

Concerns about breathing during sleep are very common, and we receive a high volume of referrals. Unfortunately, this leads to a longer wait time than we would prefer. Depending on the severity of the symptoms reported in the referral, you can expect to wait 4-12 months for an initial appointment. Should symptoms worsen while you are awaiting your appointment, you can discuss with your physician who may send an update if appropriate.

What can I do while I’m waiting for my appointment?

If you are concerned about your child’s snoring and/or pauses in breathing, and your physician has prescribed a nasal steroid spray or a medication called montelukast, it is important to use this/these on a regular daily basis while awaiting your appointment. If this has not been prescribed, please consider discussing this option with them. This will help us decide on next steps once we see your child. It is important to know that these medications do not have an immediate effect, and you may not notice any effect for many weeks. If there are side effects of concern, please discuss these with your child’s physician to decide i the medication should be stopped. If your child’s symptoms resolve with this treatment, we ask that you cancel your referral to help keep space for those patients with ongoing symptoms.

If your child has difficulty falling or staying asleep, please see our Sleep Resources page and implement healthy sleep hygiene strategies, prior to your appointment.

If your child has autism, please attend the Foundational Family Services Sleep Solutions Workshop prior to your appointment.

Looking for more resources or supports on sleep concerns in childhood?

Visit our Sleep resource and support page to find helpful websites, local contacts, videos and more.

Information for healthcare providers

The CHEO Sleep and Home Ventilation Clinic is focused on the assessment and management of breathing-related sleep disorders (ex. obstructive sleep apnea), from birth to 18 years, focused on those with complex medical and/or developmental histories.

Given prolonged wait times, referrals for otherwise healthy patients aged 14-18 years may not be accepted based on current referral volumes. For these patients, we recommend referral to either the Royal Ottawa Sleep Centre or West Ottawa Sleep Centre/MedSleep.

We also accept referrals for initial assessment of patients with symptoms raising concern for narcolepsy (ex. true hypersomnolence, ie. severe difficulty staying awake during the day, despite appropriate amount of sleep at night; sleep attacks, cataplexy, etc). You may also refer these patients to Neurology. If seen in Sleep Clinc, and diagnosed with Narcolepsy, patients will be referred to Neurology for further management. If narcolepsy (and sleep-related breathing disorders) are ruled out, care will be returned to the referring provider.

At this time we do not accept referrals for behavioural sleep disorders, including:

parasomnias (sleepwalking/sleeptalking/night terrors)

insomnia (sleep-onset and sleep maintenance)

delayed sleep phase disorder

If your patient has any of the above sleep-related concerns, we recommend:

Provide family with link to CHEO Sleep Resources page

If patient has autism, suggest family attend the Foundational Family Services Sleep Solutions Workshop

Champlain Base eConsult to Dr. H. Myron

Or, if > 14yo referral to Royal Ottawa Sleep Centre or West Ottawa Sleep Clinic/MedSleep

If a patient has concerns of both sleep-disordered breathing, and other respiratory issue (ex. asthma) and you wish both to be addressed, please state this clearly in the referral. A separate referral to Respirology Clinic is not required. However, please make clear in the referral if you wish both to be addressed.

Sleep studies

For more information or to make a referral to CHEO’s Sleep Laboratory and sleep studies, visit CHEO’s Sleep Lab page.

If you want to refer to BOTH Sleep Clinic AND for a Sleep Study, BOTH forms must be completed. Note: waitlist and triage are separate.

Make a referral

Our clinic is now accepting e-referrals with Ocean!
If you’re already on Ocean, look us up via your account by searching "CHEO".
If you don’t yet have an Ocean account, no problem - signing up is free.
Make a referral in Ocean

All patients must be referred by a Physician. You can make an e-referral using Ocean, or mail or fax the referral form to us.

Sleep and Home Ventilation Clinic referral form

Referral criteria and eligibility

Referral criteria and eligibility:

Healthy children aged 0-14 years with respiratory symptoms of a sleep-related breathing disorder
Complex (medical and/or developmental) children aged 0-18 years with respiratory symptoms of a sleep-related breathing disorder

Referral criteria
Reason for referral	Mandatory information to include in referral to facilitate accurate triage
Assessment re: Obstructive sleep apnea Central Sleep Apnea Hypoventilation	Relevant clinic information: Nocturnal symptoms: snoring - < 3 nights/wk or > 3 nights/week witnessed pauses with effort – occasional/frequent gasping – occasional/frequent labored breathing mouth breathing secondary enuresis Daytime symptoms: morning headaches excessive somnolence irritability poor concentration poor/declining school performance Physical examination findings: tonsil size BMI percentile Past Medical History. Please specify if any of the following: Obesity Genetic disorder/Syndrome - specify Epilepsy Congenital heart anomaly Pulmonary illness (ex. asthma)
Assessment re: Narcolepsy	Relevant clinic information: Nocturnal symptoms: snoring - < 3 nights/wk or > 3 nights/wk witnessed pauses with effort – occasional/frequent gasping – occasional/frequent labored breathing mouth breathing secondary enuresis Daytime symptoms: morning headaches impact on daytime functioning excessive somnolence daytime naps (>4yo) symptoms of cataplexy Physical examination findings: tonsil size BMI %ile Past Medical History: Neurologic disorder Mental health disorder (depression, anxiety) Genetic syndrome Family History: Narcolepsy (Type 1 or 2)

Other information

Failure to include above requested information may impact our ability to accurately triage the referral
For symptoms of OSA, please prescribe a 3 month trial of regular daily nasal steroid and/or montelukast based on relevant indications/contraindications pending assessment in Sleep Clinic
Please cancel the referral if:
- Symptoms resolve with the above
- Symptoms resolve spontaneously
- The patient is assessed by ENT and plans made for adenotonsillectomy
If symptoms worsen while your patient is awaiting their sleep study, please do not hesitate to send us a clinical update (please identify as an update to the previous referral and cite date of original referral)
Please note that referrals will be cancelled if the family does not attend a confirmed initial appointment, or if we receive no response after 3 attempts over a month to schedule an appointment. As such, please ensure contact information is accurate on the referral, and please provide an update if information changes.

Contact us

Respirology Clinic (C-9), CHEO
401 Smyth Road
Ottawa, ON K1H 8Li
Fax: 613-738-4298
Main Clinic Reception (scheduling center) 613-737-7600 extension 2222

Our staff will not provide information to families of children or youth not already seen by a CHEO Respirologist. After your child has been seen, we encourage you to register for CHEO My Chart and contact us though there. You can reach the following members of our team through CHEO MyChart:

Sleep Clinic Nurse Practitioner
Home Ventilation Nurse Practitioner
Home Ventilation/Complex Lung Disease Respiratory Therapist
Respirology Clinic Nurse-Coordinator
Asthma Educator