Sleep Apnea is a very serious problem that in infants and is more prevalent if they are premature. There are three

types of apnea; central, obstructive and mixed. Any of these can affect an infant, though obstructive sleep apnea is more common. Obstructive sleep apnea is also on the sleep disordered breathing (SDB) spectrum along with snoring and obstructive hypoventilation. Any sleeping and breathing problem should be quickly investigated by a physician as it can become life threatening if left untreated.

What Are the Different Kinds of Sleep Apnea?

Central apnea is a condition in which the brain doesn’t send the signal to breathe and that results in weak or no muscle coordination for breathing. Obstructive sleep apnea, the most common, is a caused by an obstruction that narrows or closes the airway. The last type, mixed sleep apnea, is a combination of the previous two.

Infant apnea is defined as American Academy of Pediatrics as “an unexplained episode of cessation of breathing for 20 seconds or longer, or a shorter respiratory pause associated with bradycardia, cyanosis, pallor, and/or marked hypotonia.” Typically it is the primary caregiver who usually reports the symptoms to the physician.

How Common Is Infant Sleep Apnea?

Infant apnea is common among premature infants due to their low weight and gestational age. With the exception of infants delivered prior to 28 weeks, most infants outgrow the condition. Sleep apnea is also common in infants with respiratory infections. This clears up when the infection clears up and the respiratory tract is back to normal.

How Is Sleep Apnea Diagnosed?

Typically sleep apnea is diagnosed by your infant’s pediatrician. If your child shows symptoms of sleep apnea, you should make an appointment with your pediatrician or pediatric dentist without delay. Your pediatrician will give your child an examination and ask questions to try to determine the severity of the sleep apnea. If your child’s condition warrants it, for example, if your child has a fever or a cough, additional tests may be performed. There are no imaging tests that can detect sleep apnea.

Many infants will be transferred to sleep specialists who will conduct multichannel sleep studies.  If your child is referred for a polysomnography, a sleep study, the child will spend the night and as they sleep their breathing rates, blood pressure rates, and if it is suspected that they suffer from central sleep apnea their brain waves may also be monitored. If the child has an interruption of breathing during the study, then the diagnosis of sleep apnea will likely be rendered. The specialist may then send your child to an eye, ear, nose and throat specialist or to a dentist who is a specialist in sleep disorders. If you live near Columbus, Ohio the dental specialist may very well be Mark Levy, DDS. If you suspect your infant has sleep apnea you can call his office at (614) 777-7350. He can help guide you through the process and become part of the team that determines the treatment.

How Is Sleep Apnea Treated in an Infant?

In young children the dentist can make a dental appliance that the child wears at night. This appliance helps to keep the mouth in a position that facilitates an open airway. With infants this isn’t possible.

The treatment for an infant is usually CPAP machine. This machine is placed over the child’s face as they sleep. It keeps a small amount of pressure on your infant’s airway as they sleep. The airway stays open and the child sleeps more restfully. How long this treatment is needed will be determined by your physician. Keep in mind that infants who had sleep apnea are more likely to have it again as they get older and their teeth are coming in. This is where a dentist trained in the Healthy Start system can help.

If your pediatrician thinks it is necessary your infant may be put on a home monitoring system. Contact with the company that handles the monitoring is usually handled by a sleep apnea service. They also provide data about your infant’s history and if necessary, can facilitate admitting or transferring your infant to a tertiary care pediatric facility.

Another treatment that seems promising is caffeine citrate. It appears that the caffeine can be a respiratory stimulant that helps infants overcome what was a developmental problem due to their age. This is particularly true of premature infants whose respiratory systems may not yet be fully developed. Unfortunately, it doesn’t work on all infants, but it is a promising treatment for those it does work on.

The bottom line is that infant this is a very serious problem and should be attended too quickly. Though there is no direct link yet it is believed that Sudden Infant Death Syndrome could be related.

If you want further information about sleep apnea in infants, or to schedule to have your child evaluated by Dr. Mark Levy, DDS, please contact the office at (614) 777-7350.