By Drs. Sally Robinson and Keith Bly

Apnea is a brief pause in a person’s breathing pattern, usually for about 20 seconds or longer. Everyone experiences these pauses from time to time; however, sometimes these pauses in breathing can cause problems. There are several causes for apnea, including:

·        enlarged tonsils or adenoids (glands located in the neck)
·        being overweight
·        congenital abnormalities of the face, neck or throat
·        medications
·        prematurity
·        gastroesophageal reflux (GERD)

There are three types of apnea: obstructive (common in children and caused by an obstruction of the airway), central (least common form of apnea, which occurs when the part of the brain that controls breathing does not start or maintain breathing properly) and mixed (combination of obstructive and central, and seen mainly in infants and young children who have abnormal control of their breathing).

Obstructive apnea occurs in about 3 percent of all otherwise healthy preschool-age children. It is most likely to occur during sleep, because that’s when soft tissue in the throat is most relaxed. Obstructive sleep apnea may disturb sleep patterns, and children who suffer from it may be tired during the day. Other symptoms of obstructive apnea include snoring, gasping for air, restless sleep and unusual sleeping positions, mouth breathing, weight loss or poor weight gain in infants, behavior problems, bedwetting, and change in color (blue or pale).

To treat obstructive apnea, your child’s doctor may want to perform an adenotonsillectomy (surgical removal of tonsils and adenoids) or may need to use continuous positive airway pressure, which involves having your child wear a nose mask that blows air into the child’s throat while he is sleeping.

Central apnea is most commonly seen in premature infants, because the respiratory center in the brain is not fully developed. It often has a neurological cause, and the hospital may send your child home with an apnea monitor. Mixed apnea may appear whether the child is awake or asleep.

Conditions associated with apnea include:

·        An Apparent Life-Threatening Event is a combination of apnea, change in color, change in muscle tone, choking or gagging. If you suspect your child is having an ALTE, call 911.

·        Apnea of Prematurity occurs in babies born before 34 weeks of pregnancy. Treatment involves keeping the infant’s head and neck straight (always place your infant on her back to sleep to keep the airways clear), medications to stimulate breathing, and continuous positive airway pressure.

·        Apnea of Infancy affects children under age one who were born after a full-term pregnancy. AOI usually goes away on its own and does not cause significant problems.

If you think that your child may have apnea, contact your doctor to have your child evaluated. Most often, apnea can be treated, and in many cases it goes away on its own.

Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email jskoloen@utmb.edu.