When Does Sleep Apnea Start in Babies?

Sleep apnea may be more common in adults, but it can occur even in early stages of an infant’s life.

When does sleep apnea start in babies? Infant sleep apnea could start as early as an infant’s first month, especially if the baby is born preterm. In fact, preterm infants can start showing symptoms of sleep apnea starting on the 2nd day.

As you read on, you’ll discover more about what could trigger sleep apnea in babies, and find out why it happens.

What is Infant Sleep Apnea?

Infant sleep apnea is a breathing disorder in babies characterized by the pauses and reduced breathing during sleep.

To be more specific, “apnea” is a term that means pauses in breathing. “Hypopneas”, on the other hand, is a term used to describe partial reductions in breathing.

These pauses and reductions in breathing happen when the infant is at their rapid eye movement (REM) stage. It is the stage of sleep where a person’s eyes are moving randomly and rapidly, and is also believed to be the phase where we are visited by dreams.

As mentioned earlier, sleep apnea usually occurs in preterm babies. But for full-term newborns, it is not as common. In fact, there is an 84% chance of developing sleep apnea for babies weighing less than 2.2 lbs, 25% for babies who weigh more than that but less than 5.5 lbs, but a highly rare chance of it happening for babies weighing more than 5.5 lbs.

What Types of Sleep Apnea Can Infants Have?

Sleep apnea comes in different forms:

Central apnea – This occurs when the brain does not send the right signal to the body, making the body decrease or stop its effort to breathe.
Obstructive apnea – This occurs when the soft tissue at the back of the throat relaxes and collapses into the airways, blocking the air from effectively coming in or out.
Mixed apnea – This happens when a mix of central apnea and obstructive apnea occurs.

For small premature babies, it is usually a case of mixed apnea. For full-term and larger premature infants, central apnea is the most common.

Obstructive apnea happens in infants, but the cases are rare.

What Causes Infant Sleep Apnea?

When it comes to infants, sleep apnea generally comes from two main reasons:

A developmental problem

Remember that central apnea is the most common form of sleep apnea in infants, and this is usually because of improper brain function. This happens because the brain stem has not yet developed fully, and is still unable to function the way it’s supposed to function.

The good thing about this is that once the body has fully-developed, the baby’s sleep apnea may also go away.

A secondary problem caused by a medical condition

Especially for preterm babies, it is common for them to have other medical conditions. Because of this, it is possible for the sleep apnea to be a complication of those medical conditions.

In this case, the sleep apnea may go away once these other medical issues have been addressed.

What are the Symptoms of Infant Sleep Apnea?

How do you know if your baby has sleep apnea?

Here are some of the most common symptoms:

Your infant pauses in between breaths, with each pause possibly lasting for around 20 seconds or longer
You notice a steady pattern of repeated pauses as the baby sleeps, with each pause lasting for less than 20 seconds
Your infant’s heartbeat is slower than normal
Your infant has low oxygen levels
Your infant needs resuscitation and other forms of urgent care

What are the Possible Complications?

Having infant sleep apnea can lead to a number of different complications. These are the two most common complications you’ll see in infants who have sleep apnea:

Hypoxemia is a condition where not enough oxygen is sent to the blood.
Bradycardia is a condition where the infant’s heartbeat becomes abnormally slow.

It’s also possible for the infant to lose consciousness every so often. This may result in the need to resuscitate.

What are the Risk Factors?

When it comes to babies, sleep apnea can either be a product of a number of different medical conditions, or could make existing conditions even worse.

Here are some of the risk factors involved in infant sleep apnea:

Acid reflux
Anemia
Infections
Lung disease
Neurological issues
Problems with metabolism
Seizures
Smaller upper airways

It has also been found that most babies who die from suddent infant death syndrome (SIDS) have exhibited symptoms of sleep apnea before death. However, sleep apnea is not considered as a risk factor for SIDS.

How is Infant Sleep Apnea Treated?

The treatment for sleep apnea vary, depending on how mild or serious the case is. There are usually two options — via machine or through medication.

Machines meant to treat sleep apnea help infants breathe better and at a more normal pace. But whether your infant is subjected to medicines or hooked up to a machine, either way, the option will only be short-term.

That’s the good thing about sleep apnea in infants. It is often temporary, and will go away as the child grows. In fact, 98% of preterm infants who have sleep apnea would lose the symptoms by the time they reach the 40th week after conception.

As for those who are born less than 28 weeks after conception, the symptoms may stay a bit longer.

Do Kids Get Sleep Apnea Too?

Although sleep apnea in infants go away eventually, it doesn’t mean that kids are not at risk. In fact, where obstructive sleep apnea is less common in infants, it is much more common in children.

How do kids get sleep apnea?

Children can get sleep apnea for the following reasons:

Other family members also having obstructive sleep apnea
Enlarged tonsils or adenoids
Being overweight
Presence of other medical conditions like cerebral palsy or down syndrome
Narrow airways coming from problems with the jaw, mouth or throat
A larger than usual tongue, causing it to obstruct the airways while sleeping

What are the symptoms of sleep apnea in kids?

Here are some of the most common symptoms of sleep apnea in children:

Snoring, snorts or gasps while sleeping
Abnormally heavy breathing while sleeping
Restless sleep, often changing positions and having unusual sleeping positions
Bedwetting
Behavioral problems
Sleepiness during the daytime
Night terrors
Sleepwalking
Having a hard time waking up in the morning
Having trouble focusing or paying attention

How is sleep apnea diagnosed in children?

When you see a number of symptoms that suggest your child has sleep apnea, doctors will recommend having your child be checked by a sleep specialist and coming in for a sleep study.

What happens during a sleep study?

The child will go through a polysomnogram, which is completely painless and risk-free. Your child would have to stay the night at the sleep center, however, as there are a number of things that would have to be checked while your child sleeps at night.

Some of the areas doctors will be look at are:

Body movements
Blood oxygen levels
Brain waves
Breathing patterns
Carbon dioxide levels
Eye movements
Heart rate
Sleeping positions
Snoring and other sounds made while sleeping

How is pediatric sleep apnea treated?

Treatment would depend on where the sleep apnea is coming from.

For kids whose tonsils are usually enlarged, your doctor may refer you to an ear, nose and throat doctor (ENT). The ENT may recommend surgery to remove either the tonsils or the adenoids.

If the problem is weight-related, then your doctor may recommend a strict diet and lifestyle change for your child. Excess weight especially around the neck area could constrict the airways, making it difficult for them to breathe properly while sleeping.

For other cases, continuous positive airway pressure (CPAP) therapy might be advised. This requires the child to sleep with a mask on. The mask is attached to a machine that pumps air into the airways.