Sleep apnoea living in infants

Overview

Sleep apnoea in infants is a condition where a baby stops breathing for short periods during sleep. It happens because the part of the brain that controls breathing is not fully mature, or because the airway is blocked. It is different from sleep apnoea in adults and often gets better as the baby grows.

Yes, sleep apnoea is fairly common in premature infants. Up to half of babies born very early may have it. It is less common in full-term newborns.

It mainly affects premature infants, especially those born before 32 weeks. Full-term newborns can also have it, but this is less common and often related to other health issues.

Symptoms

Common symptoms

• Pauses in breathing that last 20 seconds or longer
• A bluish or pale colour around the lips, face, or tongue (cyanosis)
• Slower than normal heart rate (bradycardia)

Symptoms in children

• In older children, sleep apnoea may show as loud snoring, restless sleep, bedwetting, or daytime sleepiness.

Symptoms in older adults

• This article focuses on infants; sleep apnoea in adults is a different condition with its own symptoms, such as loud snoring and gasping for air.

Causes

Main causes

• An immature breathing control centre in the brain (common in premature infants)
• Blockage of the airway (for example, from a small jaw or enlarged tonsils – rare in newborns)
• An underlying medical condition, such as an infection, anaemia (low red blood cells), or a heart problem

Risk factors

• Premature birth (before 37 weeks)
• Low birth weight
• Family history of sleep apnoea
• Certain neurological conditions or birth defects affecting the brain or airway

When to see a doctor

See a doctor urgently if:

• If you notice your baby stopping breathing for longer than 20 seconds or turning blue
• If your baby seems very floppy or unresponsive during a breathing pause

Book a routine appointment if:

• If you observe irregular breathing patterns and are concerned, it's always right to discuss them with your doctor
• At regular well-baby checkups, mention any concerns about sleep or breathing

Diagnosis

Doctors diagnose sleep apnoea by monitoring your baby's breathing and heart rate while they sleep. This often happens in the hospital, especially for premature babies.

Tests that may be done

• Cardiorespiratory monitoring (tracks breathing and heart rate)
• Oximetry (measures oxygen levels in the blood)
• A sleep study (polysomnography) if needed – but this is less common in infants

What to expect at your appointment

Your doctor may keep your baby in hospital for a period of observation. If your baby goes home, you may be given a home monitor to track breathing. The care team will teach you how to use it and what to do if an alarm sounds.

Treatment

Treatment depends on how severe the apnoea is and what is causing it. Many babies, especially those born prematurely, simply outgrow it with time. For those who need help, treatment focuses on supporting their breathing until their brain matures.

Self-care at home

• Always place your baby on their back to sleep – this is the safest position
• Keep soft bedding, pillows, and toys out of the cot to reduce any risk of airway blockage
• Use the home monitor exactly as your doctor advises
• Learn basic infant CPR – ask your healthcare team for training

Medical treatments

Doctors may use a medication that stimulates the baby's breathing centre (a respiratory stimulant) to help reduce the number of pauses. If the apnoea is more severe, they may provide extra oxygen or a machine that delivers gentle air pressure through a small mask to keep the airway open. These treatments are always supervised by a medical team.

When is surgery considered?

Surgery is rarely needed for infant sleep apnoea. It may be considered only if there is a clear physical blockage, such as enlarged tonsils or a structural problem in the airway. This is more common in older children than in newborns.

Living with this condition

Living with infant sleep apnoea involves a lot of gentle monitoring. You may need to keep a watch on your baby's breathing during sleep, especially if you have a home monitor. It's normal to feel anxious, but you are not alone – your healthcare team will support you.

Lifestyle tips

• Follow safe sleep guidelines: back to sleep, firm mattress, no loose bedding
• Keep your baby away from tobacco smoke and other air pollutants
• Attend all follow-up appointments and ask questions when you need to

Diet and exercise

For infants, feeding is the main focus. Ensure your baby gets enough milk to grow well – a healthy weight can help with breathing. Gentle play during awake times is good for development. Your doctor will monitor growth closely.

Mental health and emotional wellbeing

It is very common for parents to feel worried, tired, or even overwhelmed. You might have trouble sleeping yourself because you are watching your baby. These feelings are normal. Talk to your doctor or a counsellor if you need extra support.

Prevention

Infant sleep apnoea cannot always be prevented, because it often relates to how early a baby is born. However, good prenatal care and avoiding smoking or infection during pregnancy can help reduce the risk of premature birth.

Vaccines

Make sure your baby gets all recommended vaccinations on schedule. Some infections can worsen breathing problems, so preventing illness is helpful.

Screening programmes

In hospital, premature babies are closely monitored for apnoea from birth. There is no routine screening for full-term babies unless they have symptoms or risk factors.

Complications

If left untreated

• Repeated drops in oxygen levels can affect a baby's growth and brain development
• It may cause feeding difficulties and slow weight gain
• In very rare cases, severe and untreated apnoea could lead to long-term health problems

Long-term outlook

The outlook is excellent for most infants. Sleep apnoea in newborn and premature babies almost always resolves as the brain matures – often by the time the baby reaches their original due date or a few months after. With proper monitoring and medical care when needed, the vast majority of babies grow up healthy without any lasting effects.

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