Sleep apnea in children: How to make sure they get rest

Nov 13

I recently took my daughter to the doctor because her snoring at night was so loud! They asked if she had sleep apnea and I had no idea what that meant. Within 10 minutes of her falling asleep that evening, I noticed it. She would take long pauses between breathing (uncomfortably long) and then suddenly gasp for air. This happened over and over again. I couldn’t help but feel absolutely terrible! How could I not know?

The reality is, sleep apnea in babies and children is often elusive in its early stages, is nonetheless a puzzle that parents can piece together with the right knowledge and support. In the hopes to help out others, I did a little research.

What is sleep apnea?

Sleep apnea is a disorder that disrupts the natural breathing pattern during sleep. This interruption not only fragments sleep but can lead to a host of health issues if left unaddressed. In children, this condition is often characterized by pauses in breathing that can last a few seconds to minutes. These pauses, known as apneas, can occur multiple times per hour, each time momentarily pulling a child from the restorative sleep they need.

Two main types of this condition can impact our little ones:

Obstructive Sleep Apnea (OSA)—OSA occurs when an infant’s airway is partially or completely blocked during sleep. This blockage is physical, making it difficult or impossible for the baby to inhale properly despite their efforts.

Central Sleep Apnea (CSA)—Unlike OSA, CSA is caused by irregular brain signals interfering with an infant’s natural breathing rhythm. Here, the issue is not an obstructed airway; instead, the infant does not try to inhale due to these disrupted signals from the brain.

Understanding the types of sleep apnea and their implications is crucial for parents and caregivers, setting the stage for recognizing symptoms and seeking timely intervention.

Risk factors of sleep apnea for babies

When assessing the risk of sleep apnea in infants, their time in the womb can play a significant role. Preterm infants, particularly those born earlier than 28 weeks, are highly susceptible to apnea. As these tiny bodies are still developing, the reflexes that control breathing aren’t fully established, making apnea a common concern.

Full-term babies are less likely to experience sleep apnea but are not entirely immune. The complexities of how and why sleep apnea develops in infants are intricate and not wholly understood. It’s also critical to recognize that while certain conditions may increase the risk, they do not guarantee the development of sleep apnea. With this in mind, let’s explore the factors that might tilt the scales toward the occurrence of OSA and CSA in babies.

Risk factors for obstructive sleep apnea (OSA)

Several variables can elevate an infant’s risk of the airway blockages characteristic of OSA:

Neuromuscular Disorders—Babies with conditions that weaken airway muscles, such as Down Syndrome or Cerebral Palsy, are at a heightened risk for their airway collapsing during sleep.
Environmental Factors—One such example is exposure to secondhand smoke, which has been associated with an increased incidence of OSA in infants.
Congenital Anomalies—Infants born with structural peculiarities in their craniofacial regions or airways may be predisposed to OSA.
Gastroesophageal Reflux (GERD)—This common condition in infants can lead to or exacerbate OSA, particularly when the baby has a pre-existing upper airway anomaly.
Cleft Palate—An infant with a cleft palate may encounter airway size and function challenges, increasing the risk for OSA.

Risk factors for central sleep apnea (CSA)

CSA in premature infants is often linked to an immature brainstem, which is crucial in controlling respiration. Factors that can trigger CSA due to their effect on the brain’s respiratory center include:

Gastroesophageal Reflux—Similar to its effect on OSA, GERD can also increase the risk of CSA.
Head Trauma—Any injury to the head can disrupt the brain’s respiratory control center.
Exposure to Toxins—Environmental toxins can adversely affect the brain’s ability to regulate breathing.
Metabolic Disorders—These conditions can interfere with the brain’s respiratory center’s normal function.
Genetic Disorders—Conditions such as Down Syndrome and Arnold-Chiari malformation are known to contribute to the risk of CSA.
Infections—Certain infections, including meningitis and pertussis, can heighten the risk.

Symptoms of sleep apnea

The manifestation of sleep apnea in babies can be both subtle and overt, often escaping the notice of even the most attentive caregivers. The hallmark of sleep apnea is a noticeable cessation of breathing during sleep. In infants, this pause typically extends beyond 20 seconds and can be accompanied by a range of symptoms that may vary in their visibility and frequency, such as:

Struggling for breath—The effort to breathe may become more apparent with the baby exhibiting labored breathing.
Mouth breathing—If an infant breathes through their mouth instead of their nose during sleep, it may indicate an obstructed nasal passage.
Restlessness—Infants might seem to wake frequently during the night, a sign that their sleep cycle is being interrupted.
Respiratory infections—A pattern of recurring respiratory infections could suggest the presence of sleep apnea.
Snoring—Infant snoring can be a telltale sign of disrupted airflow.
Sweating—Excessive sweating during sleep can be a response to the stress of struggling to breathe.
Developmental delays—Over time, untreated sleep apnea may impact a child’s growth and development due to the disruption of restorative sleep.
Swallowing difficulties—Challenges with swallowing might be related to the structural issues that can contribute to sleep apnea.

Caregivers need to be observant of these signs. Although an infant may not display all of these symptoms, the presence of one or more warrants attention and further evaluation by a healthcare professional. Detecting and addressing sleep apnea early can be crucial for an infant’s overall health and developmental trajectory.

Treatment for sleep apnea in babies

Addressing sleep apnea in infants often involves personalized care that considers the severity of the condition and any additional health issues. Many preterm infants outgrow sleep apnea by their expected due date.

When symptoms persist, treatment becomes crucial to prevent complications. This typically involves a coordinated effort from a medical team. For central sleep apnea linked to other medical conditions, treating the underlying issue may resolve the apnea.

Milder cases of obstructive sleep apnea may just need monitoring. If more intervention is required, options include supplemental oxygen, positive airway pressure therapy, or surgery to clear airway obstructions.

Treatments are carefully balanced against potential risks, always with the infant’s health and growth in mind.

Supporting your little one’s sleep

Sleep apnea for babies is a condition that, while serious, is diagnosable and manageable with the right approach and resources. If you have concerns about your child’s breathing or sleep patterns, it’s essential to consult with healthcare professionals who can offer a precise diagnosis and tailor a treatment plan specific to your child’s needs.

As a parent, it can be daunting to face health issues with your little one, and you may sometimes feel helpless. However, there are steps you can take to support your child’s sleep health. Establishing a consistent bedtime routine, creating a soothing and safe sleep environment, and being mindful of your child’s sleep behaviors are proactive measures that can have a significant impact on their sleep quality.

And remember, My Sweet Sleeper is here to support you every step of the way.

Our pediatric sleep consultancy services provide families with the guidance they need to overcome childhood sleep challenges. We offer empathetic, expert advice to help your child—and your entire family—achieve the restful sleep necessary for health and happiness.

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