Babies can experience sleep apnea, a condition where breathing repeatedly stops and starts during sleep. This sleep-related breathing disorder can affect infants and newborns, potentially impacting their growth and development, and warrants medical attention.
Types of Sleep Apnea in Infants
Infants can experience different forms of sleep apnea, categorized by the underlying cause. Obstructive Sleep Apnea (OSA) occurs when the airway becomes physically blocked or narrowed during sleep, preventing sufficient air from reaching the lungs.
Central Sleep Apnea (CSA) occurs when the brain fails to send proper signals to the breathing muscles. There is no physical obstruction; instead, the brain momentarily “forgets” to tell the body to inhale. CSA is more prevalent in premature infants due to their immature central nervous systems.
Mixed Sleep Apnea is a combination of both obstructive and central types, meaning an infant experiences both airway blockages and lapses in brain signals. While central apneas are common in preterm infants, mixed apneas are often seen in very small premature infants.
Recognizing the Signs
Parents and caregivers should observe a baby’s sleep patterns for signs of sleep apnea. One of the primary signs is a pause in breathing during sleep, which typically lasts 20 seconds or longer. Shorter pauses might also indicate sleep apnea if accompanied by other symptoms, such as a drop in heart rate or bluish discoloration of the skin around the mouth or nose.
Loud snoring, noisy breathing, or gasping and snorting sounds during sleep are common indicators of obstructive sleep apnea. Babies with sleep apnea may also exhibit restless sleep, frequent awakenings, or unusual sleep positions as they try to find a way to breathe more easily. During the day, affected infants might show excessive sleepiness or irritability, poor feeding, or difficulty gaining weight due to interrupted sleep.
Causes and Risk Factors
Various factors can contribute to the development of infant sleep apnea, often linked to the type. For Obstructive Sleep Apnea, enlarged tonsils and adenoids are common causes, as these tissues can physically block the airway. Craniofacial abnormalities, such as a small jaw or cleft palate, can also predispose an infant to OSA by narrowing the airway. Certain genetic syndromes, including Down syndrome, can increase risk due to muscle weakness or specific facial structures.
Central Sleep Apnea is frequently associated with prematurity, particularly in infants born before 37 weeks of gestation, because their brainstem, which controls breathing, is still developing. Neurological conditions, infections like meningitis, or metabolic disorders can also affect the brain’s ability to regulate breathing. Certain medications might also contribute to CSA.
Diagnosis and Treatment
Diagnosing sleep apnea in infants typically involves a comprehensive evaluation by medical professionals. The primary diagnostic tool is polysomnography, often referred to as a sleep study. This overnight test monitors various physiological parameters, including brain activity, heart rate, oxygen levels, breathing patterns, and muscle activity, to identify and characterize breathing disruptions during sleep.
Treatment approaches for infant sleep apnea are individualized based on the type and severity of the condition. For Obstructive Sleep Apnea, surgical removal of enlarged tonsils and adenoids (adenotonsillectomy) is a common and often effective intervention. Other treatments may include positive airway pressure (PAP) therapy, where a machine delivers air pressure through a mask to keep the airway open during sleep. Positioning strategies or weight management, if applicable, can also be part of the treatment plan.
For Central Sleep Apnea, treatment often involves careful monitoring, especially in premature infants, as many outgrow the condition as their brain matures. Medications that stimulate breathing, such as caffeine, may be prescribed. Supplemental oxygen therapy, which delivers extra oxygen through a nasal cannula, can also be used to maintain adequate oxygen levels. Overall, treatment is managed by a team of specialists to ensure the baby receives appropriate care.