When a baby gasps for air at night, snores, or has long pauses in breathing, they may have infant sleep apnea, a sleep-related breathing disorder.

Infant sleep apnea may involve pauses in breathing that last 20 seconds or longer. Shorter pauses may also be a concern if they happen along with low oxygen levels, a slow heart rate, changes in skin color, or reduced muscle tone.

Talk to a healthcare provider, such as a pediatrician, if you notice unusual breathing during sleep. If their lips or face look blue or gray, or if they’ve stopped breathing, call 911.

Having a child with sleep apnea can be frightening, especially if you don’t know what to expect. Learning about the condition can help you understand what to watch for and when to get care.

Here’s what you need to know about sleep apnea in babies, including symptoms and how doctors diagnose it. You’ll also find information on how doctors may treat the condition and steps you can take to keep your baby safe.

Types of Apnea in Babies

Complete pauses in breathing are called apneas, while episodes of reduced breathing are called hypopneas. Apnea in babies may be one of three types:

• Central apnea — This happens when the brain doesn’t send the signals needed to breathe regularly. This can slow breathing or cause complete pauses.
• Obstructive apnea — This happens when soft tissue in the back of the throat blocks the airway during sleep.
• Mixed apnea — This involves both central apnea and obstructive apnea. It’s also the most common type of sleep apnea in preterm infants.

Signs and Symptoms of Sleep Apnea in Babies

If your baby has sleep apnea, you may notice these symptoms when they sleep:

• Persistent snoring
• Gasping for air
• Pauses between breaths
• Choking
• Noisy breathing
• Breathing through their mouth
• Grunting while breathing
• Thrashing or moving a lot in their sleep
• Waking abruptly from sleep
• Opening their eyes or crying out
• Sweating

These may also be signs of sleep apnea outside of sleep:

• Frequent respiratory infections
• Difficulty swallowing
• Breath-holding episodes

Keep in mind that some of these symptoms can happen in babies who don’t have sleep apnea. For example, babies can have irregular breathing patterns that are part of their normal development.

These patterns can include brief pauses in breathing. Sometimes, a pause happens after your child moves or sighs in their sleep. These pauses are typically very short and no longer than 20 seconds.

If you see or hear something that doesn’t seem right, let your child’s pediatrician know. They can evaluate your baby and advise you on the next steps.

How Doctors Diagnose Sleep Apnea in Babies

If you think your baby has sleep apnea, start by talking with their pediatrician. They can evaluate your baby, discuss the symptoms, and recommend a pediatric sleep study if needed.

A sleep study is done in a sleep lab designed for children and can help diagnose your child’s sleep issues. During this overnight study, sensors monitor your baby’s brain waves, heartbeat, and breathing. The study also evaluates their arm and leg movements.

Doctors use this information to find out what type of sleep problem your baby has and how serious it is. With this information, the sleep medicine physician can create a treatment plan for your baby.

When selecting a facility for your baby’s sleep study, make sure it’s accredited and designed for children. Not every sleep lab will have properly sized equipment for an infant or be familiar with the unique needs of babies and children.

Treatment Options for Infant Sleep Apnea

The first step in treating apnea in babies is to check whether the baby needs emergency help or support to stay stable.

Next, doctors try to find the cause and treat it when possible. For newborns, doctors may recommend observation in a neonatal (newborn) intensive care unit (NICU) with heart, breathing, and oxygen monitors.

For premature babies, care in the NICU may be needed if breathing pauses happen often, last a long time, need repeated gentle stimulation, or happen with a slow heart rate and low oxygen levels.

Depending on the cause, treatment options may include:

• Nasal continuous positive airway pressure (CPAP) — Breathing support that sends air through the nose to help keep the airway open
• Methylxanthines — Medications, such as caffeine citrate, that stimulate the nervous system to help regulate breathing

Your baby’s treatment plan will depend on how serious their sleep apnea is and whether another health condition is affecting their breathing.

It’s important to follow the treatment plan and stay in contact with your child’s healthcare provider. Adjustments can be made if something isn’t working or if you’re concerned about your baby’s well-being.

Tips for Safe Sleep Practices

Always follow safe sleep practices when putting your baby to bed. This includes:

• Placing your baby on their back for every sleep
• Using a firm, flat mattress with a fitted sheet
• Keeping blankets, pillows, stuffed animals, crib bumpers, and other soft items out of the crib

The American Academy of Pediatrics recommends putting your baby’s crib or bassinet in your room for at least the first six months of their life.

Join the Conversation

On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

If you care for a baby with sleep apnea, what signs did you notice first? Let others know in the comments below.