How to Deal with Infant Sleep Apnea

It’s normal for all of us to have short pauses in breathing while we sleep. But for some people, including infants, these pauses are longer and more frequent.
This can cause restless sleep and lead to concerning health conditions down the road. A regular occurrence of prolonged trouble breathing during sleep is known as sleep apnea. It’s a condition that’s particularly dangerous in babies.

What is apnea of prematurity?

According to the American Academy of Pediatrics, apnea of prematurity is defined as a pause in breathing longer than 20 seconds. It may be less than 20 seconds if accompanied by bradycardia or cyanosis.
Apnea of prematurity is one of the most common respiratory problems seen by doctors and nurses in the neonatal intensive care unit.
According to the National Institutes of Health (NIH), there are several reasons why newborns may experience apnea. Babies who were born prematurely are even more susceptible. The conditions are:

  • The brain is not yet fully developed
  • The muscles that keep the airway open are weak

Newborns and premature babies in particular are often seen to have irregular breathing patterns.
These babies will have episodes of either shallow breathing or stopped breathing lasting from five to ten seconds. This is what is known as apnea. These episodes are mixed in between periods of normal breathing.
When a baby’s breathing is very shallow or stops completely, even for a few seconds, the baby’s heart rate also drops. This drop in heart rate is called bradycardia. This may result in a baby having poor color or generally being “sick looking.”
Apnea episodes lasting longer than 20 seconds are considered serious, as are those that don’t begin until after the second week of a baby’s life. It’s worthwhile to note that a small percentage of kids who die from Sudden Infant Death Syndrome, or SIDS, show apnea symptoms prior to death.
Apnea is common in premature babies and is not believed by doctors to have long-term effects. Apnea of prematurity typically goes away by the time the baby is 36 weeks old. Even so, most doctors advise that preventing severe bouts of apnea is best for the baby’s overall health.

What can I do to treat apnea?

The proper treatment for apnea depends on the cause, the frequency with which breathing stops and how severe it is.
For babies who have no underlying health issues and who have just a few apnea spells per day, doctors recommend parents and guardians simply watch them closely. When their breathing stops, they should be gently stimulated until it begins again.
Babies who are healthy but experience multiple episodes of apnea every day are sometimes given a caffeine solution to stimulate breathing. Sometimes nurses and parents may suction children with severe apnea, change their position, or use a special mask to help improve breathing.
Slower feeding times, oxygen and in some extreme cases, a breathing machine may be necessary to mitigate a baby’s apnea.

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Apnea, SIDS, and home monitoring

There isn’t a quick-fix solution to treat sleep apnea, but parents can ease their anxiety by using an apnea monitor to track and respond to their baby’s sleep and breathing conditions.
An apnea monitor checks the baby’s heart rate and respiration rate to make sure he or she is breathing properly. When either one falls below normal levels, the monitor sounds an alert to notify mom or dad that something might be wrong.
According to National Institutes of Health (NIH), it’s been more than 25 years since continuous cardiorespiratory home monitoring was suggested to decrease the risk of SIDS. Since then, researchers have been unable to establish the effectiveness of such monitoring despite multiple studies.
Doctors now counsel parents that even careful monitoring using a monitoring device does not completely prevent the sudden and unexpected death of infants. Instead, they advise that parents follow the NIH safe sleep recommendations to lower babies’ SIDS risk.
For more information about the topic, visit www.nih.gov and www.aap.org
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