An apneic spell refers to a temporary pause in breathing, primarily observed in infants, which can be unsettling for parents to witness. While often brief, these episodes represent a distinct deviation from typical breathing patterns in newborns. Understanding these spells helps parents recognize and respond to such occurrences.
Identifying an Apneic Spell
An apneic spell is defined as a cessation of breathing lasting 20 seconds or longer. Even if shorter, it qualifies if accompanied by specific symptoms. Parents should look for changes in the infant’s skin color, such as cyanosis, where the skin, lips, or nail beds may turn blue or pale due to reduced oxygen.
A significant drop in heart rate, known as bradycardia, is another indicator. The infant might also exhibit hypotonia, appearing limp or floppy. Observing these combined signs helps distinguish an apneic spell from normal variations in infant breathing.
Causes and Risk Factors
Apneic spells often occur due to an underdeveloped central nervous system, common in premature infants and termed “apnea of prematurity.” In these instances, the brain’s respiratory control centers are not yet fully mature, leading to pauses in the signals that regulate breathing. This immaturity affects both the central drive to breathe and the airway’s ability to remain open.
Beyond prematurity, other medical conditions can trigger apneic spells. Infections like respiratory syncytial virus (RSV) or sepsis can disrupt normal respiratory function. Gastroesophageal reflux (GERD), where stomach contents flow back into the esophagus, can sometimes cause a reflex leading to a breathing pause. Neurological events like seizures can also manifest with changes in breathing patterns, including apneic episodes.
Differentiating From Normal Infant Breathing
It is important to distinguish apneic spells from “Periodic Breathing of the Newborn” (PBN). PBN involves short pauses in breathing, typically lasting less than 10 seconds. These brief pauses are followed by a period of rapid, shallow breaths before the regular pattern resumes.
This pattern is a normal variation for both full-term and premature infants and does not indicate a problem. Unlike apneic spells, PBN is not accompanied by changes in skin color, heart rate drops, or limpness. Recognizing this distinction can alleviate concern.
When to See a Doctor and Diagnosis
If an infant experiences a suspected apneic spell, parents should first attempt gentle stimulation, such as lightly rubbing the infant’s back or feet. If the infant does not resume breathing promptly or if any color change persists, emergency medical services should be contacted immediately.
Following any suspected apneic spell, a pediatrician should be consulted. Diagnosis often begins with a thorough physical examination. Observation in a hospital setting may be recommended to monitor breathing patterns, heart rate, and oxygen saturation. Further investigations might include blood tests for infection or metabolic imbalances. A sleep study (polysomnography) can provide detailed information by continuously monitoring brain activity, breathing, heart rate, and oxygen levels during sleep, helping identify the underlying cause.