Last updated on Feb 3rd, 2021 at 12:00 pm

Newborn babies don’t come with instructions, but they do come with a whole new set of things for parents to worry about. One of these things is their breathing.

Fortunately, most newborn babies don’t have any breathing problems, but there are those that do. And as some parents will attest, there are few things in life scarier than finding your baby not breathing and blue in the face.

What is baby sleep apnoea?

Apnoea (derived from the Greek word for lack of breath), is defined as no breath or a pause in breath, usually for longer than 15 seconds. Sleep apnoea is actually more common than we think, in both babies and adults. The most common type is a sleep disorder called sleep apnoea – quite literally a pause in breathing while sleeping. If you have ever watched a baby sleep, you would notice that they seem to have a regular breathing rhythm with short pauses in between. These short pauses usually last for five to 10 seconds, and are followed by rapid breathing for 10 to 15 seconds. This is called periodic breathing and is completely normal.

Apnoea (pronounced ‘ap-nee-a’) happens when these pauses in breathing are longer, or the baby stops breathing altogether.

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Apnoea is also characterised by the following:

  • Lack of breath (or holding of breath) for longer than 15 seconds
  • The baby’s colour changes to a pale purple or blue.
  • A slowing of the heart rate, called bradycardia.

When all these factors are present when a baby stops breathing, it is referred to as significant apnoea or an apnoeic spell. This is not normal.

Some babies with apnoea have what is known as an Apparent Life Threatening Event (ALTE). In these cases the baby becomes floppy and could choke or gag. Some babies get stiff or have a staring spell. Sometimes the cause for an ALTE is known, for instance if the baby has an identifiable disease or condition, or if the baby inhaled vomit. In most cases, however, there is no cause, and it seems as if the baby has somehow just forgotten to breathe.

What causes apnoea?

In premature babies

There is no medical explanation for apnoea in infants, although there seems to be quite a lot of theories. Research has shown that a significant number of premature babies suffer from apnoea – the reason probably being that most babies born prematurely have immature respiratory centres (the part of the brain that controls breathing). Premature babies tend to breathe in bursts of big breaths followed by shallow breathing or pauses. Apnoea in premature babies is most common when the baby is sleeping.

In older babies or children

In older babies or children, apnoea generally occurs due to an obstruction in the airway. Persistent breathing through the mouth and loud snoring is an important symptom of this. Usually the reason for the obstruction is the enlargement of the tonsils and adenoids. Though a lot of children snore during sleep, you should consult your paediatrician if you notice your child struggling to breathe (or stop breathing altogether), if his lips turn blue while he is sleeping, or if he complains about headaches when he wakes up.

Other possible causes for apnoea include:

  • Infections
  • Low blood sugar
  • Seizures
  • Too high or too low body temperature
  • Brain injury or bleeding in the brain during delivery
  • Exposure to drugs or poisons
  • A blocked airway (as by a relaxed tongue)
  • Birth defects
  • Or a lack of oxygen in the room.

What can parents do?

The most important thing is to observe your baby’s breathing patterns regularly. If there is anything you are worried about, seek medical advice.

Tips to prevent baby sleep apnoea:

  • Your baby should always sleep flat on his back or on his side.
  • Keep your baby’s neck slightly extended when he lies down.
  • Don’t smoke near your baby.
  • Make sure that your baby’s room is not too cold or too warm.

Read more on sleep apnoea in babies here.