Sleep Apnea

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.

 
Types of Sleep Apnea in Children
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.
 
How is Sleep Apnea in Children Diagnosed?

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.

 
Treating Children with Sleep Apnea
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

Sleep and Your 4- to 7-Month-Old

By this age, your baby should be well on the way toward having a regular sleep pattern. Some infants, particularly those who are breastfed, may still wake at night. But most no longer need a middle-of-the-night feeding.

How Long Will My Baby Sleep?

Most babies this age should sleep 12 to 15 hours a day, which includes a longer stretch at night and at least two naps during the day, says the National Sleep Foundation. The average amount of daytime sleep is now about 3 to 4 hours.

By 6 months, most babies are sleeping at night for 9 hours or longer, with brief awakenings.

How Should Babies Sleep?

The American of Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing until the first birthday or for at least 6 months, when the risk of SIDs (sudden infant death syndrome) is highest.

Room-sharing is when you place your baby's crib, portable crib, play yard, or bassinet in your own bedroom instead of in a separate nursery. This keeps your baby nearby and helps with feeding, comforting, and monitoring your baby at night. 

While room-sharing is safe, putting your baby to sleep in bed with you is not. Bed-sharing increases the risk of SIDS and other sleep-related deaths.

Follow these recommendations for a safe sleep environment for your little one:

  • Always place your baby on his or her back to sleep, not on the stomach or side. The rate of SIDS has gone way down since the AAP introduced this recommendation in 1992. Once babies consistently roll over from front to back and back to front, it's fine for them to remain in the sleep position they choose. 
  • Use a firm sleep surface. Cover the mattress with a sheet that fits snugly. Make sure your crib, bassinet, or play yard meets current safety standards.
  • Do not put anything else in the crib or bassinet. Keep plush toys, pillows, blankets, unfitted sheets, quilts, comforters, sheepskins, and bumper pads out of your baby's sleep area. 
  • Avoid overheatingDress your baby for the room temperature, and don't overbundle. Watch for signs of overheating, such as sweating or feeling hot to the touch.
  • Keep your baby away from smokers. Secondhand smoke increases the risk of SIDS.
  • Put your baby to sleep with a pacifier. But if your baby rejects the pacifier, don't force it. If the pacifier falls out during sleep you do not have to replace it. 
  • Watch out for other hazards. 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. Look around for things that your baby can touch from a seated or standing position in the crib. Hanging mobiles, wall hangings, pictures, draperies, and window blind cords could be harmful if they are within a baby's reach.

Helping Your Baby Sleep

You may have started a bedtime routine that you're sticking to. If you haven't yet, now is a good time to start. Soothing activities that lead up to "night-night" time can help relax your baby. A warm bath followed by stories or singing will signal an end to the day, and these same activities can be used at bedtime for years to come.

You'll want your baby to fall asleep on his or her own. This may mean doing your nighttime routine and putting the baby into the crib while he or she is drowsy but 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 your 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 results. This can be tough for parents, since it's upsetting to hear your baby cry. If you know your baby is safe, it's OK to give him or her time to settle down.

Why Does My Baby Wake at Night?

Even a baby who has been sleeping through the night will sometimes wake in the wee hours. Allow some time to let your baby get back to sleep on his or her own. Give your baby a few fussy minutes before you respond. Then, after checking to see that everything is OK, leave your baby alone to fall back to sleep. Remember: Any cuddling, feeding, or talking you do may prompt your baby to wake each night for this attention.

Separation anxiety, a normal stage of development, can cause some babies between 6 months and 1 year old to call out or cry in the middle of the night. If this happens, as with other awakenings, give your baby some time to settle down. If needed, give brief reassurance to your little one without taking your baby out of the crib. 

When to Call the Doctor

Most infants at this age will have a regular sleep routine and are able to sleep through the night. But there is a wide range of normal. If you have any questions about your baby's sleep, talk with your doctor.

Reviewed by: Mary L. Gavin, MD
Date reviewed: February 16, 2017