If you have a new born sleeping with you or near you, it is quite likely that you will watch him or her sleeping and see that the breathing is regular. You may do this during the day or night regardless of however tired you are! Having gone through this with my own daughter, I can vouch for the fact that it’s quite natural behavior for new parents. If you’re the type to hover, don’t worry to much about it so long as you’re not being overbearing and interrupting your child’s sleep.
But there’s something that you should also be aware of when it comes to sleep disorders in children. Did you know that, like adults, babies can have sleep apnea? Adults that suffer from sleep apnea will usually wake up if they stop breathing and have disturbed sleep. But babies having infant sleep apnea may not as their reflexes may not be as well developed. According to reports and statistics around 3% babies suffer from sleep apnea. However, the actual occurrence of sleep apnea in babies is often underreported and the rate may be closer to 10%.
What Are The Symptoms Of Sleep Apnea In Babies?
You should definitely be concerned if you see one or more of these symptoms of sleep apnea in babies:
Snoring, particularly if it is constant- Noisy breathing
- Frequent waking
- Disturbed sleep
- Weird sleeping positions
- Constant tiredness
- Finding it difficult to keep awake during the day
- Pauses in breathing
- Heavy breathing with difficulty when awake
- Excessive fussiness and irritability
If your baby is premature or has a heavy birth weight, you should be all the more concerned. That is because in a tiny baby the breathing mechanism may not be fully developed. And an overweight baby may have a compromised airway due to excessive fat around the neck resulting in sleep apnea.
When Should You Be Concerned?
If your small baby (six months or less) has periodic breathing (rapid, slow, shallow, pause) then this is quite normal as long as the pause is not longer than 20 seconds. Irregular breathing is quite common in small infants! I must admit this freaked me out quite a bit, especially since I was primarily responsible for my newborn daughter’s sleep training.
If the pauses are longer, then it is more likely to be sleep apnea and needs to be taken care of. Infant sleep apnea can have serious and long term consequences. It can result in:
- Lung damage – this can be compounded in babies with weaker or not fully developed lungs.
- Cardiovascular disorders – because sufficient oxygen does not reach the blood, the heart has to pump harder. This causes an increase in blood pressure and can lead to various heart problems.
- Developmental problems – apart from delayed milestones, babies with sleep apnea may have ADHD when older. Normal behavioral development may also be adversely affected thanks to irregular sleeping and waking up.
- Nutritional deficiencies – if your baby does not feed sufficiently because of constantly falling asleep he or she may not feed adequately and then suffer from poor physical and mental growth.
If, at any time, your baby seems to be turning blue, he will need CPR and you should call emergency services!
What Are The Possible Causes of Infant Sleep Apnea?
Just like in adults, there may be different reasons for infant sleep apnea. It may be possible that there are medical reasons for the sleep apnea and that is all the more reason for it to be diagnosed early, so that the appropriate treatment can be given. Among the causes for sleep apnea are:
- Neurological problems
- Anaemia
- Swollen tonsils
- Infection
- Any kind of lung disease
- Acid reflux
- Narrow airway
- Metabolic diseases
There are two different kinds of sleep apnea in babies. One is OSA (obstructive sleep apnea) and the other is CSA (central sleep apnea). Or they may be a combination of both. OSA usually occurs if the soft tissue in the back of the throat is lax and blocks the airway. CSA happens when the brain does not send signals to the muscles to breathe. Premature and underweight babies are more likely to develop CSA or mixed apneas. Full term and heavy babies are more likely to develop OSA. Of course the risk of both is small, but that is no consolation if your baby suffers from any kind of sleep apnea. If you’re suspicious in any way, I wold recommend getting baby breathing monitor so that you can have some empirical evidence to share with your pediatrician.
In the event that you might be curious about the most common causes of sleep apnea in babies, these tend to be abnormalities of the airway. They’ve all got really weird names (eg. laryngomalacia) but they all refer to a specific structure in the airway either being too narrow, malformed or simply prone to collapse during regular respiration. Interestingly enough, cleft palates and tongue ties should not be ruled out so it’s always a good idea to act on these with immediacy!
What Interventions Exist For Babies With Sleep Apnea?
Your pediatrician may recommend that your baby undergoes a sleep study to diagnose sleep apnea. Till the time you go to a doctor for a diagnosis and want to try non-medical interventions you can:
- Nudge the baby gently awake to start – this is the simplest method to restart breathing.
- Turn the head if this helps. Or change the baby’s position–preferably to a side-sleeping position
- Pick up the baby and hold him/her in your arms to get him to breathe.
- Use a sleep apnea alarm that will go off when the baby stops breathing, notifying you so that you can wake up the baby. Various monitors are now available and these are a safe and non-invasive method of dealing with infant sleep apnea.
If the issue is severe, you’d ideally want to treat this quickly and effectively. This may entail any of the below:
- Metabolic or neurological disorders may need medical or surgical treatment.
- Acid reflux may also be treated in a number of ways. These could be simple means such as elevating your baby’s head, using infant antacid, or leveraging surgery.
- Your baby may be helped by having a nasal cannula put in the nose to help with the breathing.
- Depending on the severity and kind of sleep apnea, your baby may be helped by a CPAP machine.
- Some babies may need to be on oxygen to help them get the oxygenation they need.
The good news is that most babies outgrow the sleep apnea by the age of one year. Those that do not still have option available for treatment–it’s all about finding the right path to wellness.
When you are a new parent you are probably over cautious and protective and perhaps even overwhelmed by the responsibility and workload that taking care of a new baby involves. It is always better to err on the side of caution where sleep apnea is concerned because apart from the short term distress, the long term consequences are not easy to deal with. Recognize that a problem exists, get a diagnosis and act on it as soon as you can!
Has your child ever been affected by sleep apnea? How about anyone else you may know? It would be great to share your story with other readers in the comments below! All the best.
–Josh