Obstructed sleep apnea in children occurs when your child experiences brief pauses in their breathing pattern that last from a few seconds to minutes, resulting in your child feeling tired and sleepy the next day.
There are several types of apnea in children:
- Obstructive sleep apnea: This is the most common type of apnea and is usually caused by a blockage of the airway due to enlarged tonsils and adenoidal tissue near the nasal passages.
- Central sleep apnea: This happens when the part of the brain that controls breathing doesn’t start or maintain the breathing process properly. Common in very premature infants.
- Mixed sleep apnea: A combination of central and obstructive apnea, mixed apnea is usually a sign of an immature breathing pattern and may occur when a child is awake or asleep.
A sleep medicine expert can help get to the bottom of your child’s sleep issues with an overnight sleep test called polysomnography, which will measure your child’s quality, quantity and breathing patterns during sleep.
Depending on the results from your child’s sleep study, treatments for apnea may include:
- medications: to relieve nasal congestion and allergies
- increased activity and better nutrition: recommended for overweight children
- continuous positive airway pressure (CPAP): a nasal and/or mouth mask that forces air to send oxygenated air into the air passages and lungs
- surgery: to remove large tonsils and adenoids that make it difficult to breath
From Nemours' KidsHealth
- Should I Be Worried About My Child's Nightmares?
- What Causes Night Terrors?
- Sleep and Your Preschooler
- Night Terrors
- All About Sleep
- Sleep and Your 1- to 3-Month-Old
- Sleep and Your 8- to 12-Month-Old
- Apnea of Prematurity
- Bruxism (Teeth Grinding or Clenching)
- Sleep and Your 1- to 2-Year-Old
- Sleep and Newborns
- Sleep and Your 4- to 7-Month-Old
- Enlarged Adenoids
- Sleep Problems in Teens
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Sleep and Your 4- to 7-Month-Old
By this age, your baby should be well on the way toward an established sleep pattern. Most likely the pattern includes at least two naps a day, plus at least 7 or 8 hours of nighttime sleep.
During these months, your baby will learn to roll over and position himself or herself for sleep. Toward the end of this period, your little one may be able to stay awake or be kept awake by surroundings, so this is the time to instill good sleep habits by sticking to a bedtime routine.
How Long Will My Baby Sleep?
While the average number of hours slept per day at this age is 14, the range of normal is quite wide, with some babies sleeping only 9 hours and others sleeping as much as 18.
The average amount of daytime sleep now is 3-4 hours. Some babies will nap 20 minutes, others will sleep much longer than average.
Remember that your baby would rather be with you than anywhere else. So your tot may need more sleep but wakes after a 20-minute nap because he or she would just rather be playing with you than sleeping. As your baby becomes a toddler and starts resisting naps, it's still a good idea to have a period of quiet time, for both of you.
Naps usually help prevent a baby from becoming too cranky to sleep well at night, allowing your baby (and you) to enjoy the waking hours more. Most babies this age like to nap once in the morning, then again sometime after lunch.
If you feel the naps are interfering with your baby's bedtime, you can wake the baby from an afternoon nap a little earlier. But if your baby is overly tired, he or she will not sleep well at night.
How and Where Should My Baby Sleep?
The American Academy of Pediatrics (AAP) recommends that healthy infants be placed on their backs to sleep, not on their stomachs. The incidence of sudden infant death syndrome (SIDS) has decreased by more than 50% since this recommendation was first made in 1992. It's now also recommended that premature infants sleep only on their backs.
Until your baby is rolling over unaided and picking a position for sleep, place your little one on his or her back to sleep. It is thought that some babies sleeping on their stomachs may have a greater tendency toward sleep obstruction and rebreathing their own carbon dioxide because they're less likely to rouse themselves to change head positions. Another possibility is that they may suffocate on softer bedding if they are lying face-down.
Always keep safety in mind. Make sure your crib meets current safety standards. Don't put anything in the crib that can interfere with your baby's breathing — stuffed animals, blankets, or soft pillows can fall on a baby's face and block breathing. Although bumper pads were widely used in the past, they are no longer recommended. A study, using data from the Consumer Product Safety Commission (CPSC), found a number of accidental deaths appeared to be related to the use of bumper pads in cribs and bassinets. The AAP and other pediatric organizations strongly discourage the use of bumper pads in cribs to avoid accidental suffocation.
Also, avoid items with strings, ties, or ribbons that can wrap around a baby's neck, and objects with any kind of sharp edge or corner. Babies can also get tangled in hanging mobiles, so remove them as well. Don't forget to look around for the things that your baby can touch from a standing position in the crib. Wall hangings, pictures, draperies, and window blind cords are all potentially dangerous if left in a baby's reach.
Many cultures endorse cosleeping. But studies indicate that there is a greater incidence of SIDS in households where the infant slept in the bed with the parents. Use of substances that decrease the parents' awareness, such as alcohol, also may allow a parent to roll over onto the baby.
You have probably already established a bedtime routine and are staying with it. If you haven't established one, start now. Soothing activities that lead up to "night-night" time can help relax your baby. A warm bath followed by stories or singing will signal transition to sleep, and these same activities can be used at bedtime for years.
You'll probably want your baby to start falling asleep on his or her own. This may mean performing your nighttime routine and putting the baby into the crib while he or she is still awake. If the baby cries, stay away for a few minutes. Your baby may settle down and go to sleep.
If the crying continues, go back in and soothe the baby for a moment without picking him or her up. This may go on a few times until your baby figures out that the crying is not getting anywhere. Expect that this may be a difficult exercise for you, simply because it's upsetting to hear your baby cry. Try to remember that if you know your baby is safe, a little crying now so that you can all sleep better later is ultimately the healthier choice.
Even a baby who has already been sleeping through the night (anywhere from 7-12 hours) will occasionally awaken in the wee hours. After ruling out teething pain, illness, or an extremely soiled diaper, it's best to let your baby struggle back to sleep on his or her own. Give your baby a few fussy minutes before you respond, then after seeing that everything is OK, leave your baby alone to fall back to sleep. Don't forget that any cuddling, feeding, or talking you do may prompt your baby to wake each night for this attention.
If your baby is waking up many times each night, perhaps there is an external reason. Is your baby too big for the bassinet? Move him or her to a full-size crib. Do you still have the baby in your bedroom? Your little one may be sensitive to your presence and may need to be put in his or her own room to get a good night's sleep. Is the baby's room too warm? Too cold? Too dark? Explore these possibilities.
Another common sleep "problem" at this age is the early riser — the baby who begins to babble or cry for you before the crack of dawn. There is probably nothing you can do to prevent your baby from waking when ready, but a few safe toys in the crib may soothe your baby for a while longer and a window shade to keep out the first light of day may let you get another few minutes of sleep.
When to Call the Doctor
If you have ruled out external reasons for nighttime waking and you still think your baby's not sleeping enough (or is even sleeping too much!), don't hesitate to call your doctor.
Teething pain is a common reason for sleep problems at this age, and the doctor may be able to suggest some ways to relieve your baby's discomfort. Perhaps there is an illness involving no other symptoms besides sleeplessness, or maybe your doctor can help you find ways to enhance your nighttime routine with your baby.
Reviewed by: Steven Dowshen, MD
Date reviewed: September 2011