Sleep Apnea in Infants

Apnea in infants is not the same as sleep apnea in adults. It is unfortunate that the names are similar. Infant apnea refers to the stopping of breathing for 20 seconds or more (less time if the baby turns blue before 20 seconds). Infant apnea is most common in babies who are preterm. It can also occur in term infants. Preterm infants usually outgrow apnea of prematurity. However, any infant with suspected apnea should be evaluated by a pediatrician without delay.

Causes

An immature respiratory center is the most common cause of infant apnea. Other causes include infection, maternal drug use, carbon monoxide poisoning, seizure and choking. It is important to know that a 20-second pause in respiration is normal as long as it is not accompanied by color change or abnormal movements, including absence of movement. Infants with structural abnormalities of the airways are also at risk for apnea.

Discussions With the Doctor

One of the most important things to tell the pediatrician who sees the infant after the episode is whether or not the baby turned color. Any color change should be noted. Some infants turn pale or red instead of becoming blue. The baby's response to stimulation should be observed. Most infants begin to breathe again if they are merely picked up or touched. The pediatrician will want to know if the baby is breast or bottle fed and if she chokes or coughs when fed. He will also ask if the baby had vomited near the time of apnea. If the infant is on an apnea monitor at home, bring it to the emergency room visit to be checked with the hospital monitors for accuracy.

Treatment

Treatment depends on the determined cause of infant apnea. Hospitalized premature infants who have apnea are treated with caffeine or aminophylline. These medications stimulate the infant just enough to "remind" him to breathe regularly. Electronic monitoring continues for a period of time after the medication is discontinued to be sure the infant has matured enough to prevent further episodes. Infant apnea determined to be the result of infection requires treatment with antibiotics or antivirals. If the cause of an apneic episode is related to choking or gastrointestinal reflux, those conditions will be identified and treated as well. Home monitoring may be necessary after an event for a period of time before it is determined that there is no further risk.

Relationship to Sudden Infant Death Syndrome

There is no known correlation between infant apnea and sudden infant death syndrome (SIDS). According to eMedicine, an online clinical reference for healthcare professionals, 90 to 95 percent of infants who died from SIDS never had a previous episode of apnea.

Likelihood of Recurrence

The likelihood of recurrence is low unless the underlying condition is not addressed. Apnea of prematurity only lasts until the respiratory center is developed. Infection is treated and gastrointestinal reflux and seizures are managed. The most important factors are thorough examination and treatment.