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
- Night Terrors
- Sleep Problems in Teens
- Sleep and Your Preschooler
- Should I Be Worried About My Child's Nightmares?
- Enlarged Adenoids
- Sleep and Your 1- to 3-Month-Old
- Sleep and Newborns
- Sleep and Your 8- to 12-Month-Old
- Bruxism (Teeth Grinding or Clenching)
- All About Sleep
- What Causes Night Terrors?
- Apnea of Prematurity
- Sleep and Your 4- to 7-Month-Old
- Sleep and Your 1- to 2-Year-Old
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Sleep and Your 1- to 3-Month-Old
Congratulations! Now your baby will probably begin to stay awake longer during the day and sleep more at night. Probably — but the range of normal is still very wide.
Your baby's sleep phases are much the same as your own: drowsiness, REM (rapid eye movement) sleep, light sleep, deep sleep, and very deep sleep. Your baby might start sleeping through the night now — but the definition of "sleeping through the night" at this age is a stretch of only 5 hours!
How Long Will My Baby Sleep?
Since babies are more alert and aware of their immediate surroundings during the daylight hours, they're more inclined to sleep during the night, especially if parents fight the urge to play or talk to their baby during nighttime feedings or diaper changes.
Your baby is adapting to the sleep-wake cycle that parents favor, and the baby's stomach is growing and holding more breast milk or formula. At 3 months of age your baby will likely sleep about 15 hours out of each 24-hour period, and two thirds of that sleep will take place during the night.
Most babies will have settled into a daily sleep routine of two or three sleep periods during the day, followed by "sleeping through the night" for 6 to 7 hours after a late-night feeding.
If your baby is sleeping a lot when you want him or her awake — or vice versa — encourage wakefulness during the day while also allowing your baby to have distinct sleeping periods. You also can rouse your baby for the late-night feeding at a time that suits your sleep schedule. For instance, if your baby gets sleepy after the 7 p.m. feeding and sleeps until 2 a.m. before feeding again, wake the baby to feed at 11 p.m. and then put him or her down to sleep until an early-morning feeding at 5 or 6 a.m. It may take a few nights to establish this routine, but it will happen if you're consistent.
If your baby wakes during the period that you want him or her to be sleeping, keep activity to a minimum. Change or feed your baby in the dark, and don't play with the baby. Your little one will start to get the message that you're a bore during the night, so he or she might as well just go back to sleep.
Again, not all infants keep to the same timetable. If you have questions or concerns, check with your doctor.
Where and How 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 is now also recommended that premature infants sleep only on their backs.
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're lying face-down.
Once your child is rolling over on his or her own, around 5 to 6 months of age, you no longer need to worry about sleep positioning. If you have difficulty getting your baby to sleep on his or her back before this age, though, talk to your doctor.
Always keep sleep 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 become a problem. Although bumper pads were widely used in the past, they are no longer recommended. A study, using data from the U.S. 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 cords, 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 potentially harmful if within 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.
If you haven't already, try establishing a bedtime routine that will be familiar and relaxing for your baby. Bathing, reading, and singing can be soothing for parents and babies and signal an end to the day. Be consistent, and your baby will soon associate these steps with sleeping.
Remember: if part of your bedtime routine is to rock your baby for half an hour, then whenever waking during the night your baby is going to expect and need that step to get back to sleep. Ideally, your baby should be put into a crib or bassinet while drowsy but still awake. This way your baby will learn to fall asleep on his or her own.
Although it may be hard at first, some experts suggest this is also the age to start letting your baby fuss for a few minutes when he or she wakes during the night. Your baby may simply be in a phase of light slumber, even though you think your baby is totally awake. Some babies squirm, whine, and even cry in their sleep before putting themselves back to sleep.
Unless you suspect that your baby is hungry or ill, try to see what happens if you leave your baby alone. It will help you all in the long run if your baby can develop the skill of going back to sleep without your help.
When to Call the Doctor
If your baby's sleep habits concern you, speak with your doctor, who can reassure you or get to the root of a physical problem that may have no other symptoms besides crankiness or sleeplessness.
Either way, the doctor can help get you on the right track . . . the one that leads to more quality sleep for your baby and for you!
Reviewed by: Steven Dowshen, MD
Date reviewed: September 2011