The OHSU Doernbecher Pediatric Sleep Lab program is struggling with capacity and financial issues due to increased demand and a shortage of regional providers. As the only program in Oregon providing advanced pediatric sleep care, it handles over 1,000 annual sleep studies, mainly for underserved populations, leading to long wait times and affecting related surgical services. Interviews and assessments revealed operational inefficiencies with long patient wait times and a high rate of rescheduling or cancellations. This crisis affects various surgical services that are dependent on the sleep lab, thereby hindering clinical and research advancements. Two recommendations were made: one involves immediate independence and expansion through significant funding, building a state-of-the-art 12-bed facility, and hiring additional staff. The other is a multi-phased approach, optimizing current resources, reducing cancellations, and improving bed utilization while planning gradual expansion. Both strategies emphasize demonstrating the lab's value through key performance indicators as well as financial returns.