As you have not mentioned; the pediatric patient's age or his birth history (was he born preterm, Term, low birth weight or like that ? So, what ever information you have provided; it could be

1. Apnea of prematurity

2. Apnea of newborn

Thank you Nazia for pointing that out. I’ve add the relevant info.

7 year old most likely may have adenoid hypertrophy and tonsillar hypertrophy leading to OSA episodes.

- Respiratory center stimulation leads to ---sudden inward movement of rib cage when patient is in expiration phase of respiration---Rib cage is still immature so the inward movement is more than usual and poorly. coordinated-causing muscular strain and one of the reason for the pain.

- Increasing exertional work on the extra thoracic muscles.

- change in the acid base and corresponding electrolytes change leading momentarily myositis another reason.

based on the given information, it is possible that the patient is experiencing a form of paroxysmal nocturnal dyspnea (PND), which is characterized by sudden episodes of difficulty breathing at night. This condition is often associated with heart failure or other cardiac conditions. The bearhug-like rib pain may be related to the effort required to breathe during these episodes. The patient's technique of taking short-burst inhalations may have helped to increase oxygen saturation and alleviate his symptoms. However, it is important that the patient receives a medical evaluation to determine the underlying cause of his symptoms and to receive appropriate treatment.

Need more detalis

So here's an update. Thank you to those who posted answers.

Possible causes of recurrent, paroxysmal bearhug pain and inspiratory arrest in a 7 year-old:

• intermittent upper airway obstructions (e.g. tonsillar hypertrophy and edema, worse supine)
• central apnea ± obstructive apnea
• repeated electrical injuries
• repeated panic attacks
• factitious disorder
• acute, recurrent cramping of the bilateral intercostal muscles
• acute, recurrent cramping of the diaphragm

Please feel free to comment or add suggestions. Ty! DG