Ashwin Lewis
It can be distressing for parents to witness their newborn gasping for air in their sleep. While occasional gasps are typical, persistent and frequent episodes can indicate underlying health issues. Newborns may gasp for air due to various reasons, including respiratory infections, asthma, laryngomalacia, second-hand smoke exposure, sleep apnea, and pertussis infection. Understanding the root causes, identifying symptoms, and implementing suitable measures can help address this issue.
| Characteristics | Values |
|---|---|
| Occurrence | Occasional gasps during sleep are typical |
| Root causes | Respiratory infection, asthma, laryngomalacia, secondhand smoke exposure, sleep apnea, and pertussis infection |
| Solutions | Safe sleeping environment, head elevation, optimal room conditions, regular tummy time, breastfeeding, proper feeding techniques, consistent routine, saline drops, etc. |
| Diagnosis | Airway endoscopy, polysomnogram, overnight sleep study in a sleep lab |
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What You'll Learn
Newborns' lungs are not yet ready
In addition to the immaturity of the autonomic nervous system, other factors contribute to newborns' lungs not being fully ready at birth. The extra tissue around the baby's voice box can cause gasping noises, and in some cases, laryngomalacia, a congenital abnormality of the cartilage in the larynx, can lead to noisy breathing and gasping. This condition usually resolves on its own by the time the baby turns one or two years old.
To reduce the risk of newborns gasping for air in their sleep due to immature lungs, parents can take several measures. Ensuring proper feeding techniques, such as keeping the baby upright while feeding and burping them afterward, can help prevent swallowing excess air. Elevating the baby's head while sleeping, maintaining optimal room conditions, and using a humidifier can also facilitate smoother breathing and reduce the occurrence of gasping.
While occasional gasps during sleep are typical, persistent and frequent episodes can be a cause for concern. If you notice any colour change in your baby, consistent fast breathing, or other distressing signs, it is essential to consult a paediatrician or healthcare professional to rule out potential respiratory issues or other underlying conditions.
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Sleep apnea
There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea. OSA occurs when an infant's throat narrows or closes, blocking the airway during sleep. This type of sleep apnea is often associated with abnormalities in the structure of the face, head, or upper airway (larynx), as well as gastroesophageal reflux and cleft palate. On the other hand, central sleep apnea is caused by the brain failing to send proper signals to the body, resulting in a decrease or pause in breathing efforts. This can be due to an immature brainstem or a secondary medical condition. Additionally, certain neurological disorders, such as Down syndrome and cerebral palsy, can increase the likelihood of developing sleep apnea by affecting the muscles involved in breathing.
The frequency of sleep apnea episodes increases during REM sleep, and premature infants tend to have more REM sleep than full-term infants, making them more susceptible to sleep apnea. Apnea is considered a pause in breathing that lasts 20 seconds or longer for full-term infants, and it is diagnosed when pauses in breathing during sleep meet this duration criterion. Shorter lapses in breathing, lasting less than 20 seconds, may also be indicative of sleep apnea if accompanied by other symptoms such as a reduction in heart rate or bluish colouring of the skin.
To manage sleep apnea and reduce the occurrence of gasping episodes, parents can take several steps. These include ensuring a safe sleeping environment, elevating the baby's head during sleep, maintaining optimal room temperature and humidity, encouraging regular tummy time to strengthen neck and shoulder muscles, and adhering to consistent feeding and sleeping routines. Breastfeeding is also recommended as it may reduce the risk of sleep apnea. In more severe cases, medical interventions such as oxygen supplementation, breathing support machines, and medications may be necessary.
While sleep apnea in newborns can be concerning for parents, it is important to remember that it is usually temporary, and most babies outgrow it within a year. However, if parents have any concerns or notice persistent and frequent gasping episodes, it is crucial to consult a healthcare professional for guidance, diagnosis, and personalised treatment options.
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Gastroesophageal reflux disease
While it can be distressing for parents to witness, it is not uncommon for newborns to experience periodic breathing, where they breathe rapidly and then slow down, occasionally pausing for a few seconds. These gasps are often part of an infant's natural breathing patterns and development, particularly during the early weeks. However, gastroesophageal reflux disease (GERD) can also cause newborns to gasp for air in their sleep.
To treat GERD, your baby's doctor may recommend feeding them a thick formula to help reduce reflux. They may also suggest elevating the baby's head while sleeping by placing a small, folded towel or blanket beneath the mattress's head to facilitate better airflow. Additionally, the crib should be safety-approved with a firm mattress and a close-fitting sheet. The baby should always be placed on their back to sleep, as the side position is not safe because babies can roll over.
If lifestyle changes are not effective in managing your infant's GERD, your doctor may prescribe medication to block and lower the amount of stomach acid. However, it is important to note that these medications are not currently approved by the FDA for GERD treatment.
In summary, while GERD can be a cause of newborn gasping during sleep, it is important to consult with a paediatrician to rule out any other potential respiratory issues or concerns.
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Respiratory infections
Viruses are the leading cause of respiratory infections in newborns. Rhinoviruses, influenza, parainfluenza, respiratory syncytial virus, enterovirus, coronaviruses, and some strains of adenoviruses are commonly implicated in respiratory tract infections. These viruses can cause inflammation and irritation of the airways, leading to gasping for air during sleep.
Newborns are particularly susceptible to respiratory infections due to their immature immune systems and developing lungs. Their narrow airways can easily become blocked or inflamed, causing breathing difficulties. Additionally, newborns tend to breathe through their noses, and respiratory infections can cause nasal congestion, further impeding their ability to breathe smoothly.
To prevent and manage respiratory infections in newborns, it is essential to maintain a hygienic and smoke-free environment. Exposure to secondhand smoke can irritate the airways and increase the risk of respiratory infections. Breastfeeding is also beneficial, as it boosts the newborn's immune system and helps protect against infections.
If you suspect your newborn is experiencing respiratory distress due to an infection, it is crucial to seek medical attention promptly. A healthcare professional will perform a physical examination, assess the baby's vital signs, and may recommend further tests or treatments to alleviate the infection and improve breathing.
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Neurological disorders
While occasional gasps during sleep are typical for newborns, persistent and frequent episodes can indicate underlying neurological issues.
In some cases, skull and facial abnormalities, such as a pushed-back or small chin, can also contribute to breathing difficulties. Additionally, neurological problems can affect the heart or blood vessels, resulting in the heart not pumping enough blood to the brain to trigger the signal to breathe.
If you suspect that your newborn's gasping for air is related to a neurological disorder, it is essential to consult a healthcare professional for a precise diagnosis and personalised treatment plan. Specialists such as pediatric pulmonologists, otolaryngologists, neurologists, and pediatricians with training in sleep disorders may be involved in evaluating and treating your child.
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Frequently asked questions
Newborns may gasp for air in their sleep due to various reasons, including:
- Their breathing is paused, and they gasp for air once they start breathing again.
- They have swallowed excess air while feeding.
- They are experiencing reflux.
- They have sleep apnea.
- They are exposed to second-hand smoke.
Obstructive sleep apnea (OSA) occurs when the passages between the nose and the lungs are narrowed, causing interruptions in breathing during sleep. It is common in premature babies and those with certain neurological disorders, such as Down syndrome.
Here are some measures you can take to help your newborn:
- Elevate your baby's head while sleeping by placing a small, folded towel or blanket beneath the mattress.
- Ensure your baby is sleeping on their back on a flat surface.
- Keep the room at a comfortable temperature and humidity level.
- Avoid exposing your baby to second-hand smoke.
- Consult a healthcare professional if you are concerned or notice any distressing signs.
