What is Obstructive Sleep Apnea or OSA in babies? Do you know the signs and symptoms to check your baby’s breathing properly whilst asleep?
If your little one is constantly on the roundabout of sleep coaching, you’ve read every book, tried different sleep programs and perhaps even previously engaged a sleep consultant, you may feel you’ve “tried” every settling approach under the sun…. you’ve concluded your baby is just a poor sleeper.
Spoiler alert, it’s not true! There is more to sleep than meets the eye and you don’t need to just wait it out with a “this too shall pass” approach to chronic poor sleeping patterns for you or your little one.
Think about it, has sleep has been extremely difficult from the start? Is it poor or even potentially getting harder rather than easier as they get older? Does EVERY little change in your little one’s routine sets you back to square one (think holidays or just being out of routine for a few days and it ALL falls apart). You feel like you are constantly on the sleep coaching roundabout, with little long-term improvement?
It might be time to consider the possibility of a physical impairment such as Obstructive Sleep Apnea (OSA).
As a Certified Infant and Child Sleep Consultant I DO NOT believe that every sleeping difficulty can be directly related to behavioural changes, sleep regressions/leaps or development milestones in your little one’s sleep difficulties. Instead, when addressing sleep, we need to consider other factors to ensure a holistic approach is taken and the full picture is understood.
Disclaimer: I am NOT a healthcare professional and this blog is an opportunity to open discussions, assess your little one’s sleep patterns and consider if you need to seek advice from your GP/Paediatrician to potentially obtain referral to an ENT for further investigation, advice and support.
Before we go any further into this blog, it’s important to know snoring is NEVER normal in babies/toddlers/children or even adults! It’s basically choking in our sleep!
Let this sink in for a moment….. snoring is not NORMAL!
It’s not funny (insert joke about dad or grandpa), it’s not cute (insert gushing comments about your baby), it’s not annoying (insert meme’s about smothering your partner in their sleep) and it’s also not ‘genetic’…..You definitely get the picture. Society has made snoring something to brush off as a joke or somewhat of an endearing trait and we NEED to take it more seriously.
Snoring is something we DO want to investigate further with a trusted healthcare professional, namely an Ears, Nose, Throat specialist (ENT).
What is Obstructive Sleep Apnea (OSA)?
The American Academy of Paediatrics (AAP) defines OSA as a “disorder of breathing during sleep characterised by prolonged partial upper airway obstruction and/or intermittent complete obstruction (obstructive apnea) that disrupts normal ventilation during sleep and normal sleep patterns” here.
Put simply, Obstructive Sleep Apnea is disordered breathing during sleep. This may be characterised by either partial or intermittent complete obstructive episodes, whereby breathing during sleep is suboptimal.
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The most common signs and symptoms of OSA in babies/children
- Loud Snoring – This is the most common outward symptom where you can hear audible sounds whilst sleeping.
- Respiratory Pauses – This sounds like snorting/choking/spluttering whilst your little one is asleep. They can gasp for air between breaths.
- Restless Sleep – Constant tossing about and excessively switching positions. Moving about is normal, we are looking for excessive restless sleep.
- Sweating – Excessively hot despite optimal dressing/room conditions.
- Sleeping with extended neck or other unusual sleeping positions – (Characteristically the neck will be arched back awkwardly or bottom high in the air). These positions “open” the airways making it easier for your little one to breathe.
- Slow growth and development – A direct result of the brain being starved of oxygen. This may include dropping percentile and slower to reach developmental milestones.
They may also demonstrate:
- Daytime tiredness
- Bedwetting- A sign in older children
- Behavioural disturbance – For instance aggression, hyperactivity, inattention, anxiety or moodiness
If your little one is displaying any of the above signs and symptoms it means they’re working harder to achieve sleep, which also means frequent night waking, all of which may not be linked solely to behaviour modification.
Whilst I don’t want to cause alarm, the reality is if your little one is experiencing obstructed breathing whilst they’re sleeping it can directly harm brain development. The harmful effects increase the likelihood of behavioural difficulties such as fatigue, hyperactivity, ADHD and poor concentration.
This is due to the brain’s need for unobstructed breathing, meaning the brain needs to receive free flowing oxygen throughout the course of your little one’s rest. This helps with restoring, resting and repairing. When a brain experiences deprivation of oxygen the regenerating process is impaired.
At this point, we don’t want to mask underlying physiological problems like OSA by trying to implement constant sleep coaching techniques. These will have temporary solutions, but ultimately fall apart a short time later. You could say we could sleep coach until the cows come home with little to no improvement long-term if we don’t first address the physical sleep barrier to sleep quality.
Expert Insight: Research suggests we lose 20% oxygen when we mouth breathe as opposed to breathing through our nose. One of the most common causes of the above signs and symptoms relates to Aden tonsillar Hyperplasia (enlarged adenoids and big tonsils). By removing the adenoids and tonsils, this can lead to resolution of Sleep Disordered Breathing (SDB) in a high percentage of children.
What is the best way forward if your little one is a snorer?
- Track Symptoms – If you feel your little one’s breathing is suboptimal or “abnormal” then I would highly recommend taking notes and starting to record your observations with a symptom tracker.
- Video your child whilst sleeping – These can be short 20-30 second videos (trust me these will be extremely valuable). As the saying goes “a picture is worth a thousand words” so when it comes to explaining what is happening for your little one at sleep times you can really help to make your case when speaking with your trusted healthcare professional.
- Make an appointment – Book in to see your trusted healthcare professional which may be your GP or Paediatrician and potentially research an ENT (Ears Nose & Throat Specialist). Your GP may recommend a sleep study to further investigate or base the referral on your sleep history, videos and day to day observations.
At the end of the day, sleep QUALITY is NOT the same as sleep QUANTITY, so even if your little one is sleeping well, but something is not sitting right in your gut, check out the information, start tracking symptoms and trust your Mumma’s instinct (which is rarely wrong) we just KNOW.
If your baby isn’t a snorer and you want to know why your baby isn’t sleeping, you can begin troubleshooting your little one’s sleep by working through 4 of the most common reasons babies don’t sleep. Read the Blog The 4 Most Common Reasons Why Your Baby Isn’t Sleeping.