At a Glance
Sleep apnea can occur in babies, causing repeated pauses or slowdowns in breathing during sleep. Symptoms may include pauses in breathing, noisy or labored breathing, frequent waking, or changes in skin color, but some infants show few obvious signs. Because breathing issues in infants can be serious, caregivers should talk to a pediatrician if they notice unusual breathing patterns or sleep concerns.
While it can be concerning, sleep apnea in babies isn't uncommon, especially in premature infants, and is often manageable with proper care. The condition involves pauses or slowdowns in breathing during sleep, which may be caused by immature breathing control or physical airway differences. In many cases, symptoms improve as a baby grows, but some situations require medical evaluation and treatment.
In this article, we’ll explain the causes, symptoms, and treatment options for sleep apnea in babies, and when to seek help from a pediatrician.
Sleep Apnea in Babies
Babies can experience obstructive sleep apnea, central sleep apnea, or both types of the disorder. In both types of sleep apnea, the infant's breathing repeatedly slows or stops during sleep, though the cause of these breathing pauses differs.
Obstructive Sleep Apnea
When a baby has obstructive sleep apnea (OSA), their airway becomes obstructed while they sleep. These obstructions may cause snoring, labored breathing, or problems while awake. However, not all infants that have OSA snore, and not all infants that snore have OSA.
Central Sleep Apnea
When a baby has central sleep apnea (CSA), they experience lapses in breathing during sleep because the brain doesn't properly signal the lungs to breathe. CSA in infants is often, but not always, associated with another medical disorder.
CSA occurs more frequently among preterm infants born before 37 weeks post conception. However, CSA in preterm infants usually resolves itself by 43 weeks post conception. In premature infants, the presence of CSA on the first day of life may indicate another illness is present. Usually, CSA begins between the second and seventh day of life in preterm infants.
Around 0.5% of full-term infants experience CSA, though up to 2% may experience at least one period of CSA-type episode of stopped breathing during sleep. Experts note that many babies experience normal pauses in breathing during sleep, called “periodic breathing.” These lapses last a few seconds, while the pauses associated with CSA often last over 20 seconds.
Symptoms of Sleep Apnea in Babies
The symptoms of sleep apnea in babies vary somewhat, depending on the type of sleep apnea. Babies with obstructive sleep apnea may experience these symptoms:
- Snoring
- Labored breathing or gasping for air
- Noisy breathing or snorts
- Paradoxical breathing, where the chest moves out during an inhale and in during an exhale
- Pauses in breathing
- Sweating during sleep
- Poor feeding
- Failure to thrive
Babies with central sleep apnea may experience a prolonged lapse in breathing.
Causes of Sleep Apnea in Babies
As with symptoms, the causes of sleep apnea in babies varies, depending on the type of sleep apnea.
Obstructive Sleep Apnea
These risk factors may make a baby more likely to develop obstructive sleep apnea:
- Enlarged tonsils or adenoids
- Facial abnormalities
- Down syndrome
- Neuromuscular diseases
- Gastroesophageal reflux (GERD)
- Other medical conditions
- Exposure to secondhand tobacco smoke
Central Sleep Apnea
These factors may make a baby more likely to develop central sleep apnea:
- Premature birth
- Problems with brainstem development
- Anemia
- Infection
- Low blood oxygen
- Metabolic issues
- Gastroesophageal reflux (GERD)
- Medication use
- Anesthesia use
Diagnosing Sleep Apnea in Babies
If you suspect your baby might have sleep apnea, the first step is to talk to your pediatrician. They'll review your baby’s symptoms, medical history, and overall health, and may ask about things like breathing patterns during sleep, feeding difficulties, or any episodes of pauses in breathing. In some cases, your pediatrician may also perform a physical exam to look for signs of airway obstruction or other underlying conditions.
If there's concern about a sleep-related breathing disorder, your child may be referred to a pediatric sleep specialist or another specialist, such as an ear, nose, and throat (ENT) doctor. These providers may use screening tools or recommend additional evaluations to better understand what’s causing the symptoms.
To confirm a diagnosis, doctors typically order an overnight sleep study, known as polysomnography. During the study, your baby sleeps in a monitored setting — usually a sleep lab — while sensors track breathing patterns, oxygen levels, heart rate, brain activity, and movement. Medical staff are present to ensure your baby’s safety and comfort throughout the night.
The results of the sleep study help determine whether your baby has sleep apnea, what type it is, and how severe it may be. This information allows your healthcare team to recommend the most appropriate next steps.
Treatment for Sleep Apnea in Babies
How sleep apnea in babies is treated depends on the type of sleep apnea the baby has, what might cause it, and how severe it is. When the disorder is only mild or occasional, the baby might not be given treatment. Instead, they may be watched to make sure the problem doesn't worsen. Sometimes, they may be gently touched during lapses of breathing.
In the case of central sleep apnea in premature infants, healthcare providers may give the baby caffeine to help them breathe more regularly. While the premature infant is still in the hospital, nurses may alter the baby's sleeping position to improve their breathing, remove fluid from the nose and mouth via suction, or use a mask that promotes breathing.
At home, parents and caregivers may be asked to monitor their infant's sleep using a home apnea monitor. If an underlying health issue is causing sleep apnea, that might be treated. If an abnormality that affects the airway is causing obstructive sleep apnea, surgery might be necessary to correct it.
When the sleep apnea is severe, babies may be given supplemental oxygen or air from a machine that supports breathing. However, in many infants, especially those that are premature, the problem may resolve on its own with time as their breathing matures. If parents are concerned or symptoms persist, seek medical care.
When to See a Doctor
It’s normal for babies to have occasional irregular breathing patterns, especially in the newborn stage. However, you should talk to your pediatrician if you notice frequent or concerning changes in your baby’s breathing during sleep.
Seek medical advice if your baby shows signs such as pauses in breathing, gasping or choking, noisy or labored breathing, or changes in skin color (such as a bluish tint around the lips or face). Other warning signs can include poor feeding, slow weight gain, excessive sleepiness, or frequent waking during the night.
Even if symptoms seem mild, it’s a good idea to check in with a healthcare provider if you’re unsure. Early evaluation can help identify whether your baby’s breathing patterns are part of normal development or a sign of an underlying issue that may need monitoring or treatment.
Frequently Asked Questions
Sleep apnea in babies can be serious in some cases, especially if it leads to frequent or prolonged pauses in breathing. However, many instances — particularly in premature infants — improve as the baby grows. It’s important to have any concerns evaluated by a pediatrician to determine whether monitoring or treatment is needed.
Sleep apnea is a condition that affects breathing during sleep after birth, so it doesn't directly affect a baby during pregnancy.
However, a mother’s health during pregnancy, such as conditions that affect oxygen levels or fetal development, may influence a baby’s risk of breathing-related issues after birth. If you're pregnant and suspect you may have sleep apnea, talk to your healthcare provider about evaluation and treatment, as managing sleep apnea during pregnancy supports both your health and your baby’s development.
While it's rare, severe untreated sleep apnea can lead to serious complications. Most cases in babies are identified and managed with medical care. If you notice signs like repeated breathing pauses or color changes, it’s important to seek medical attention right away.
The relationship between sleep apnea and sudden infant death syndrome (SIDS) isn't fully understood. While both involve breathing during sleep, current evidence doesn't show that sleep apnea directly causes SIDS. Following safe sleep guidelines and discussing any breathing concerns with a pediatrician are important steps for reducing risk.
Medical Disclaimer: This content is for informational purposes and does not constitute medical advice. Please consult a health care provider prior to starting a new treatment or making changes to your treatment plan.
Written by
Tochukwu Ikpeze, MD, Contributing WriterTochukwu grew up in New York and has a passion for creative and scientific writing. Tochukwu holds an undergraduate degree in Biology and Psychology, a Master’s degree in Biomedical Science, and a Medical Degree as well. In his free time, Tochukwu enjoys reading, learning, exploring various topics pertaining to the human condition and conveying that information to the public through writing.
Reviewed by
Pranshu Adavadkar, MD, Medical ReviewerDr. Pranshu Adavadkar is a board-certified sleep medicine physician and pediatrician with more than two decades of clinical experience diagnosing and treating sleep disorders in both children and adults. His clinical work focuses on conditions such as obstructive sleep apnea, insomnia, and other sleep-related breathing disorders.
