November 2020 | Reviewed by: Anne M. Morse, DO and John Saito, MD
What is infant sleep apnea?
Infant sleep apnea is a sleep-related breathing disorder. It involves reductions and pauses in breathing that occur during an infant’s sleep. Partial reductions in breathing are called “hypopneas.” Complete pauses in breathing are called “apneas.” In infancy, the frequency of these events increases during REM sleep.
The apneas in infant sleep apnea may be central, obstructive, or mixed. Central apneas occur when your brain does not send the proper signals to the body resulting in a decrease in effort to breathe and even a complete pause in breathing. Sometimes, central apneas can occur due to a problem outside the brain. As an example, a problem in the heart’s pump function can impair circulation and the brain does not send the correct signals to breathe during an infant’s sleep. Obstructive apneas occur when soft tissue in the back of the throat collapses and blocks the airway during sleep. Mixed apneas have features that are suggestive of central and obstructive cause.
Premature infants tend to have more REM sleep than full-term infants. As a result, premature infants tend to have more sleep-related breathing disorder and apneas. The majority of apneas that occur in small premature infants are mixed apneas. Apneas that occur in larger premature infants and full-term infants tend to be central apneas.
These breathing problems can cause severe complications. The infant may not have enough oxygen in the blood. This is known as “hypoxemia.” The infant also may develop a slow heartbeat. This is known as “bradycardia.” The infant even may lose consciousness and need to be resuscitated.
Infant central sleep apnea has two general causes. It can be a developmental problem that results from an immature brainstem. It also can be a secondary problem that is caused by another medical condition.
It is common for there to be some instability in an infant’s breathing. This can be a normal part of an infant’s development. Even healthy infants may have a brief central apnea. This pause may be an isolated event. It also may occur after the child sighs or moves. The duration of these normal events is very short. They rarely last longer than 20 seconds.
Obstructive apneas are rare in healthy infants. Obstructive sleep apnea may be related to underdeveloped facial features, such as a small or pushed back chin, as well as structural airway abnormalities and low tone.