Sleep apnea in babies is a sleep-related breathing disorder. This set of related conditions includes mixed sleep apnea, which is more common in premature infants, and central sleep apnea, which develops more often in full-sized infants. Parents should keep in mind that small cessations in breathing are common in babies under 6 months of age and are not considered dangerous. The following symptoms relate to the more serious breathing difficulties that can indicate sleep apnea.
Breathing Cessation Greater than 20 Seconds
A cessation of breathing during sleep in babies of 20 seconds or more is the definition of “infant apnea.” However, according to the American Academy of Sleep Medicine, breaks of breathing up to 15 seconds or so can be normal. Known as “periodic breathing,” this is not a symptom of sleep apnea and usually not dangerous. Although, it is more common in babies born prematurely. Notify your doctor if your baby has longer breaks in breathing, especially if the symptoms below are also present. If your baby does not respond to gentle nudging during these long cessations, call 911.
Infants with a forehead and/or body trunk that turn blue are exhibiting clear signs of oxygen deficiency caused from breathing difficulties. Bluish lips is sometimes normal, so be on the look out, as well, for a general ill-looking facial appearance, such as looking haggard.
Gasping and Gagging
Gasping and gagging for breath after a long cessation in breathing is a troubling symptom of sleep apnea. In central sleep apnea, the brain is essentially “forgetting” to send the signal to breath to the baby’s diaphragm. In premature babies, often the cause is central sleep apnea followed by an obstruction in breathing due to the immaturity of the respiratory system.
A further symptom of sleep apnea in infants is a limpness of muscles. Stanford sleep researcher William Dement suggests that a change in muscle tone is what to look out for, rather than a certain level of limpness. This is due to the low levels of oxygen in the extremities, as the available oxygen is primarily made available for core organ functions.
Infants with sleep apnea may exhibit a slower heartbeat than normal. This complication, known as “bradycardia,” can be dangerous, as it may lead to instances of sudden unconsciousness in which the infant needs resuscitation. Although this symptom is highly disturbing, and some may worry if it is precursor to Sudden Infant Death Syndrome (SIDS), there is no clear evidence that correlates sleep apnea with SIDS today. This stance was supported in a 2002 article in the respected "Journal of Perinatology." The researcher, Joan E Hodgman, recommends that “it is past time for the sleep apnea theory (as a cause for SIDS) to be put to rest.” However, Australian researchers reported in a 2000 study in the "Journal of Pediatrics" that infants with families with multiple cases of SIDS and obstructive sleep apnea (OSA) are more likely to have OSA themselves. In any case, you should contact your medical provider immediately to arrange sleep apnea testing if your infant exhibits a slowed heart rate.
- American Academy of Sleep Medicine: Primary Sleep Apnea of Infancy
- Stanford University: Infant Sleep Apnea
- "Journal of Perinatology"; "Effect on Sleep Position on Apnea and Bradycardia in High-Risk Infants"; Joan E. Hodgman, M.D.; March 2002
- PubMed: "Obstructive Sleep Apnea in Infants"; F. McNamara and C.E. Sullivan; March 2000