Snoring in Babies

There is a misconception that a snoring baby is one who is in deep, restful slumber. While often times snoring is due to mucus in the nostrils, in rare cases, it can be a sign of a more serious problem such as sleep apnoea.

Sleeping infant

What does normal sleep look like?
Sleep patterns of infants vary with age. In their first month of life, a newborn sleeps up to 20 hours a day. This gradually reduces to about 11 hours by the time they are 2 years old. It is normal for an infant to have short pauses in breathing followed by rapid breathing during sleep, however, this should not be seen with colour changes or loud, noisy breathing.

When snoring is harmless
In most cases, babies who snore simply have blocked noses. This is because the nasal passages of infants are very small, so even a tiny bit of dryness or extra mucus in their noses can make them snore or have noisy breathing. A stuffy nose can usually be cleared up using a simple home remedy of saline drops or may not need any treatment at all.

If the loud breathing or snoring does not resolve over a short period of time, it may be an indication of other underlying issues, requiring the attention of a paediatrician.

Infant sleep apnoea
Persistent snoring in babies may indicate the presence of a sleep-related breathing disorder called infant sleep apnoea. This is a condition where there is a pause or reduction in breathing when an infant sleeps. Infant sleep apnoea may be central, obstructive or mixed. Snoring is more commonly associated with obstructive sleep apnoea.

Symptoms
The following are some signs of the presence of infant sleep apnoea:

  • Prolonged pauses in breathing lasting 20 seconds or longer
  • A breathing pattern of repeated pauses, gasping for breath or choking
  • Persistent snoring
  • Difficulty breathing while taking naps during the day

Risk factors
Premature babies are more likely to have infant sleep apnoea than those born full-term. The risk is more pronounced during the first months after birth in infants with lower birth weight.

Apart from that, a variety of medical conditions can cause infant sleep apnoea or make it worse, including acid reflux, anaemia, infection and lung disease.

Infants with underdeveloped facial features, such as a small chin or jaw, having a large tongue, tonsils or adenoids or those with a floppy airway due to a softening of the voice box (larynx) are also at risk.

Seeking intervention
Unresolved sleep apnoea is of concern as it may affect growth and development and lead to long term physical and behavioural issues. So, if you are concerned about your baby’s consistent snoring, it’s best consult a paediatrician to get it checked. Taking a quick recording of the snoring and playing it for the paediatrician would be helpful to determine if there’s anything of concern going on. A sleep study may be recommended to monitor breathing during sleep, which can detect and identify any problems.

In most cases, infant sleep apnoea resolves as the child grows and matures. Studies have also found breastfeeding to be protective against snoring. In other cases where there are other underlying medical conditions, treatment with medications or surgery may be necessary depending on the nature of the problem.

 

References

  1. Hong H, et al. Am J Respir Crit Care Med 2018;198:15-16.
  2. American Academy of Sleep Medicine. Sleep Education. Infant Sleep Apnea. Available at: https://sleepeducation.org/sleep-disorders/infant-sleep-apnea. Accessed 13 August 2021.
  3. Healthline. Why Is My Newborn Snoring? Available at: https://www.healthline.com/health/parenting/newborn-snoring. Accessed 13 August 2021.
  4. Bonuck K, et al. Pediatrics 2012;129(4):e857-e865.
  5. Katila M, et al. Acta Paediatr 2019;108(9):1686-1694.

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