Ashwin Lewis
If your newborn gasps in their sleep, it could be due to a variety of reasons. Newborns have short sleep cycles and are constantly drifting in and out of sleep, so it is normal for them to make unusual sounds. Newborns also breathe mostly through their nose, and their airways are pretty small, so congestion and dry or swollen nasal membranes can make breathing audible. It is also common for newborns under 6 months to experience irregular breathing patterns, also known as periodic breathing, which typically starts with rapid breaths, then slower breaths, and then a pause in breathing for 5 to 10 seconds. This is because their lungs are still developing and their brains are still learning to regulate breathing. However, if your newborn is gasping in their sleep due to breathing pauses, choking, or noisy breathing, it could be a sign of sleep apnea, which requires medical attention.
| Characteristics | Values |
|---|---|
| Newborn snoring | Caused by the vibration of soft tissues at the back of the throat |
| Newborn sleep patterns | Unpredictable and restless, with unusual sounds |
| Newborn breathing patterns | Irregular breathing is normal, with short periods of faster or slower breathing |
| Newborn breathing issues | Congestion, dry or swollen nasal membranes, and upper respiratory infections can cause audible breathing |
| Newborn sleep apnea | Pauses in breathing, gasping, choking, and snoring; may be caused by anatomical factors or an underdeveloped nervous system |
| Laryngomalacia | Noisy breathing, especially when crying, feeding, sleeping, or lying down; usually gets worse over several months, then improves |
| Newborn choking | May be caused by inhaling small particles of milk or formula |
| Newborn stridor | High-pitched monotone sound caused by restricted airflow in the upper airway |
| Newborn crackles | Crackling sound caused by lower respiratory infections or other lung conditions |
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What You'll Learn
Sleep apnea
There are two types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA is caused by an obstruction or narrowing in the upper airway, which can be due to anatomical factors or abnormalities in the structure of the face or head. CSA, on the other hand, is caused by a delay in the signal from the brain telling the body to breathe. This is more rare and is often idiopathic, meaning the cause is unknown. However, it can also be associated with neurologic insults such as brain tumours, hydrocephalus, cerebral palsy, and brain injuries.
If you suspect your newborn may have sleep apnea, it is important to seek medical advice. A polysomnogram, an overnight sleep study in a sleep lab, is the recommended way to diagnose sleep apnea. Sensors are placed on the child to monitor brain waves, eye movements, breathing, heart rate, and oxygen levels. Treatment options may include a nasal cannula to deliver oxygen, caffeine therapy, or surgery to correct any obstructions. Most babies outgrow sleep apnea as their upper airways get bigger, but it is important to monitor and treat any breathing difficulties to ensure the health and safety of your child.
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Irregular breathing patterns
It is common for newborns to experience irregular breathing patterns, which is referred to as "periodic breathing". This is characterised by rapid breaths, followed by slower breaths, and then a pause in breathing for around 5 to 10 seconds, after which the pattern of rapid and slower breaths resumes. This is normal and usually resolves by the time the baby is 6 months old.
During sleep, newborns under 1 month old may briefly stop breathing and then experience a period of more rapid breathing. This is a normal occurrence, but it is not normal for babies to change colour or breathe noisily. If your baby is making choking or gasping sounds, this could be a sign of sleep apnea. Sleep apnea is a sleep disorder where the upper airway is narrowed, which restricts airflow. It can be caused by an anatomical factor that affects the shape of the airway or its ability to remain open during sleep.
If your baby is experiencing frequent pauses in breathing, snoring, choking, or gasping, you should consult a healthcare professional. A polysomnogram, an overnight sleep study in a sleep lab, is the most common test used to diagnose sleep apnea. Sensors are placed on the baby to monitor brain waves, eye movements, breathing, heart rate, and blood oxygen levels. Treatment options may include a nasal cannula, a CPAP machine, medication, a ventilator, caffeine therapy, or surgery, depending on the severity of the apnea.
Other potential causes of irregular breathing patterns include laryngomalacia, which is characterised by noisy breathing, particularly when the baby is crying, feeding, sleeping, or has an upper respiratory infection. In more severe cases, laryngomalacia can cause trouble breathing, indicated by tugging at the neck or stomach. It is often associated with gastroesophageal reflux, where food and acid travel back up the oesophagus.
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Newborn snoring
Newborns with sleep apnea may also gasp or choke in their sleep due to interrupted breathing. This can be caused by pauses in breathing, which can last for 20 seconds or longer. Other signs of sleep apnea include a slow heart rate, low oxygen levels, and a bluish tinge to the skin. If you suspect your newborn has sleep apnea, it is important to seek medical advice as it can affect their sleep architecture and cause long-term damage to the heart, brain, and other body parts if left untreated.
In addition to sleep apnea, several other conditions can cause newborns to snore or make unusual breathing sounds. These include lower respiratory infections, structural issues in the lower airway, and inhaling small particles of milk or formula. Conditions such as laryngomalacia can also cause noisy breathing, especially when the baby is crying, feeding, sleeping, or lying down. It is important to note that newborn breathing patterns are typically irregular, and short pauses in breathing are usually normal. However, if you are concerned about your newborn's snoring or breathing, it is always best to consult a healthcare professional.
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Laryngomalacia
- Prolonged pauses when breathing or apneic episodes
- Difficulty swallowing
- Poor weight gain
- Working hard to breathe
- Blue spells or cyanosis
The diagnosis of laryngomalacia is typically made by a pediatric otolaryngologist, an ear, nose, and throat (ENT) specialist. They will perform a thorough medical history, physical examination, and an in-office laryngoscopy to evaluate the baby's airway. Treatment for laryngomalacia depends on the severity of the condition. Mild cases may require no treatment or anti-reflux medications to help with spitting up. In contrast, severe cases may require surgery, such as supraglottoplasty, to open the area above the vocal cords and improve breathing and feeding. Most cases of laryngomalacia resolve without treatment by the time the infant reaches 18 months of age.
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When to seek medical attention
It is common for newborns and babies younger than 6 months to experience an irregular breathing pattern, known as "periodic breathing". This is characterised by rapid breaths, followed by slower breaths, and then a pause in breathing for five to 10 seconds. This is not usually a cause for concern and babies typically outgrow it by the time they are 6 months old.
However, if your baby is gasping in their sleep, it may be a sign of respiratory distress. If you notice any of the following symptoms, seek immediate medical attention:
- Your baby's breathing pauses often, or they stop breathing for 20 seconds or more.
- Your baby gasps, chokes, snores, coughs, or snorts in their sleep.
- Your baby has a bluish skin colour on their face, trunk, lips, or tongue.
- Your baby has a slowed heart rate, less than 80 beats per minute. A severe drop in heart rate (bradycardia) can result in a loss of consciousness.
- Your baby is using an apnea monitor and you notice any signs of trouble.
- Your baby is not breathing and, if you are certified to perform infant CPR, you may attempt it. If you are not trained, seek medical attention immediately.
If your baby is experiencing any of these symptoms, it is important to call your baby's doctor or seek emergency medical care. Do not hesitate to seek help, as prompt determination of the cause can help reduce gasping in babies and increase the chances of a full recovery.
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Frequently asked questions
Newborns often experience irregular breathing patterns, and it is common for newborns younger than 1 month old to briefly stop breathing and then breathe more quickly. This is called "periodic breathing" and is not something to worry about. However, if your newborn is experiencing prolonged pauses in breathing followed by a gasp, it could be a sign of sleep apnea.
Sleep apnea is a sleep disorder characterised by interruptions in breathing during sleep. It can be caused by an obstruction in the airway or by irregular signals from the brain.
In addition to gasping, babies with sleep apnea may also choke, snore, cough, or snort in their sleep. They may also experience pauses in breathing, a slow heart rate, or low oxygen levels.
The most common test used to diagnose sleep apnea is a polysomnogram, which involves placing sensors on your baby to monitor their brain waves, eye movements, breathing, heart rate, and oxygen levels during sleep.
Treatment for sleep apnea depends on the severity of the condition and the underlying cause. In some cases, a nasal cannula or CPAP machine may be used to deliver oxygen and keep the airway open. In other cases, medication, surgery, or caffeine therapy may be recommended.
