Have you ever noticed your baby breathing through his mouth? Is he sleeping at awkward angles? Has he been irritable or yawning excessively?
If so, then your baby could have sleep apnea.
Sleep apnea can be dangerous for adults, and even more for babies and their underdeveloped bodies.
Still, don’t panic just yet. With early diagnosis and treatment, babies can recover from sleep apnea and enjoy happy, healthy lives.
- Sleep apnea is when your baby’s breathing is interrupted during sleep.
- There are 3-types of sleep apnea in babies: Obstructive Sleep Apnea, Central Sleep Apnea, and Mixed Sleep Apnea. Obstructive Sleep Apnea is the most common type for babies
- A number of underlying conditions can cause pediatric sleep apnea, and could be caused by a lot of risk factors.
- Sleep apnea can be treated. While we provided different treatment options, it is still best to consult your pediatrician.
What is Sleep Apnea in Babies?
It’s a sleep disorder involving breathing interruptions during a child’s sleep.
With this condition, a baby stops breathing for a few seconds and up to several minutes. Because of this, the child’s oxygen levels drop for a minute or two.
When this happens, he may lose consciousness and stop breathing altogether. This is known as obstructive apnea.
When oxygen levels return to normal, the child will often wake up gasping for air. This cycle of falling asleep pauses in an infant’s breathing, and waking up can repeat several times an hour.
Aside from being exhausting, this cycle can also have serious complications.
3 Types of Pediatric Sleep Apnea
There are three types of infant sleep apnea that can affect most children:
Obstructive sleep apnea (OSA)
This is the most common form of infant and childhood sleep apnea that comes up in sleep studies, and it occurs when a child’s airway is partially or fully blocked during sleep.
Central sleep apnea (CSA)
Unlike OSA, central sleep apnea does not involve obstruction of the airway. CSA instead occurs when your child’s brain does not send signals to the muscles that control breathing support.
Mixed sleep apnea
As its name indicates, mixed apnea is a combination of OSA and CSA. It involves irregular breathing throughout sleep and partial or full blockage of the airway.
Warning Signs that Your Baby Has Sleep Apnea
If you see these signs, bring your baby in to see your pediatrician right away:
- Difficulty breathing
- Restless sleeper
- Excessive daytime sleepiness
- Grunting, loud snoring or noisy breathing
- Irregular breathing patterns
- Irritability, sleeplessness and restlessness during the day
- Shortness of breath on waking up
- Gags frequently or thrashes in her sleep
- Crying during sleep hours
- Your baby’s face turns blue at night
- Can’t stay asleep for long periods of time
- Unusual positions during sleep
- Persistent dry mouth or sore throat in the morning
What causes infant sleep apnea?
The causes of infant sleep apnea are still being studied, but below are some of the most common causes behind your child’s condition:
Some babies may have congenital abnormalities in the brain, craniofacial syndromes, or upper airway in which the throat collapses and causes severe sleep apnea.
Hyperthyroidism can also be a congenital condition that causes sleep apnea in babies.
Sleep apnea can develop in some babies who have a respiratory syncytial virus (RSV) or other respiratory infections that affect breathing.
Upper airway obstruction
Infants born with a blockage of the nasal passages, upper airways or enlarged tonsils or adenoids may have sleep-related breathing disorders.
In some cases, infants with enlarged tonsils and adenoids experience sleep apnea that only occurs during deep sleep and improves when they are awake.
Obstructive sleep apnea is more common in children born with heart problems, including congenital heart disease, than it is in healthy infants.
The more severe the cardiovascular disorder, the higher the risk for developing obstructive sleep apnea.
Other possibilities include drug reactions, injury to the brain stem, and chromosomal abnormalities.
The only way to know for sure is to bring your baby in for a full evaluation.
Risk Factors for Sleep Apnea in Babies
A few factors can make babies more susceptible to sleep apnea:
- Babies who were born prematurely may have breathing problems and already be at risk for OSA by the time they are born compared to full-term infants.
- Babies who are small for their gestational age sometimes have sleep apnea.
- Children with Down syndrome are at higher risk of OSA.
- Being overweight or obese increases the risk of both OSA and CSA in children and adolescents, plus potential for long-term complications.
- Babies who have certain genetic disorders are at risk for OSA, including Prader-Willi syndrome and Angelman’s syndrome.
Note: Identifying risk factors is not equal to having obstructive sleep apnea diagnosed, but it will help narrow down treatment options.
How Sleep Apnea Affects the Rest of a Baby’s Body
If left untreated, babies with sleep apnea are at risk of physical, mental, and emotional problems because of inadequate breathing support:
Failure to Thrive
One of the most common symptoms of sleep apnea in infants is failure to thrive. This term is used for babies who are experiencing weight loss or not growing as expected, despite their diet and medical care.
A lack of oxygen can disrupt a baby’s REM (rapid eye movement) sleep, which is when brain development occurs most rapidly. Unless you get obstructive sleep apnea treated, your baby may struggle to develop speech and language skills at an appropriate rate.
A baby may also experience behavioral issues like hyperactivity and attention deficit disorder when their brain does not receive the oxygen it needs during REM sleep.
Elevated Stress Levels
Babies with sleep apnea constantly have their sleep disrupted, and that can lead to the overproduction of stress hormones like cortisol.
Excess cortisol can impact a baby’s developing emotions:
- trouble bonding with their caregivers during infancy
- separation anxiety
- excessive crying
- Difficulty paying attention
- depression and anxiety
- difficulty calming down
- aggression driven by fatigue and frustration caused by lack of sleep
All of these make life challenging for both the child and their caregivers.
The good news is that early detection and intervention can have a significant positive impact on children with sleep apnea. Co-sleeping with your baby will help you detect symptoms, or even monitor your baby’s sleeping patterns. If you suspect that your baby may have sleep apnea, seek prompt help if you suspect OSA in your child.
How Doctors Diagnose Sleep Apnea in Babies
Sleep apnea testing is done by a pediatrician or sleep specialist. Your healthcare provider will ask about your child’s medical history and symptoms, and the doctor will do a physical exam to identify any medical problem.
If there are no significant medical problems, the doctor may refer you to an overnight sleep study and a test called a polysomnogram (PSG). This is the most common way to confirm the diagnosis of sleep apnea in children.
- For this sleep study, an EEG monitor and electrodes are placed on your child’s head, face, chest, legs, and arms.
- Other sensors are used to measure heart rate and rhythm, breathing rate and depth, blood oxygen levels, eye movements (REM), muscle activity (EMG), and snoring.
Children who have mild symptoms may also be referred to an ENT specialist for a physical exam of their throat and soft tissue.
How to Treat Sleep Apnea
Depending on the diagnosis, treating infant sleep apnea may involve surgery, various drugs, or behavioral interventions. Here are some examples:
- Your baby may need surgery for enlarged tonsils and adenoids that are blocking their airway
- Heartburn medication may be prescribed for acid reflux that causes their throat to relax and obstruct the airway while they sleep
- Continuous positive airway pressure CPAP therapy for children who have sleep apnea
- Provide breathing support by teaching children how to breathe through their nose
- Re-training their body’s sleep patterns to encourage restful sleep (read: Nap Advice: How Do Daycares Get Babies to Sleep?)
- Prescribing sleep medicine and an apnea monitor to track when his breathing stops
- Having parents learn infant CPR for severe issues breathing during sleep
There’s Hope for Babies with Sleep Apnea
Although pediatric sleep apnea can be very serious, if it is treated early and thoroughly, your child should have no lasting effects that can’t be managed with current medications and treatments. The key is early detection to avoid any emergency.
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