8 month old baby with strange breathing behavior at night

[hbdub]

We are extremely concerned with an unusual breathing behavior that our 8 month old daughter often displays while sleeping.  To date no doctor has been able to give us a clear diagnosis.  The behavior is similar to the gasping a baby might do after intense crying, as is she was trying to catch her breath.  However, our baby will periodically exhibit this breathing while sleeping, with no apparent cause.  This breathing behavior usually wakes us up out of a sleep as it is so loud we can hear it over the monitor.  It does not appear to wake our daughter up, but she is observed to gasp, whimper and let out brief cries throughout the episode.  We have never witnessed any significant color changes, so we assume she is getting enough oxygen, but her breathing does appear to pause for approximately 4-5 seconds in between the quick breaths. Sometimes the breaths are so intense she starts to snort and it is very frightening to watch.  It rarely will stop on its own and usually my husband and I have to go to her and intervene.  Usually we start by rubbing her back or changing her position (both of which rarely work), but we eventually resort to picking her up to wake her.  Sometimes she wakes easily, but, often, our attempts to intervene agitate her and she starts to cry- sometimes hysterically. However, once she is fully awake, the breathing behavior stops and she is happy, quiet and back to our sweet little girl.  We usually get her back to sleep soon after the behavior stops and she tends to have a restful sleep the rest of the night.  We have videotaped the behavior and shown it to several doctors including her family doctor, 2 pediatric neurologists, an ENT, and we have had a sleep study (which came back completely normal).  Unfortunately, no one can tell us definitively what this behavior is, but several theories have been given including obstructive sleep apnea,  GERD, dreaming/night terrors/nightmares, seizure activity, or just a normal part of REM sleep.  However, none of these seem to fit the bill completely as 1) no physical obstruction has been found that would cause obstructive sleep apnea (e.g., enlarged adenoids or tonsils or some kind lesion) and apnea was not seen during the sleep study, 2) our daughter does exhibit mild reflux symptoms (i.e., occasional gagging, spitting up, choking) and we have tried prescription Prevacid, but this did not eliminate the behavior.  We actually took her off the medication thinking that perhaps the medication was causing the symptoms as one of it's rare side effect is abnormal dreaming (see #3)  3) for a while, we were thinking that maybe dreaming or night terrors were to blame secondary to the hysterical crying upon trying to wake her and the immediate restoration of happiness only after fully waking, but many doctors have said she is to young to have such dreams  4) an EEG has been done both on its own and during the sleep study which did not show any abnormalities that would suggest seizure activity and 5) all babies and adults go through REM sleep so, if it is simply a symptom of that, then why isn't this behavior more widely described?  Any information that can be given would be greatly appreciated as we have had so many sleepless night worrying about this and we are exhausted.  We and our doctors have seem to hit a brick wall as far as diagnosing this problem and we feel as though all we are left with is to "go home, manage it as best we can, and hope she grows out of it," but, as loving parents, that is very hard to do as all the "what ifs" come to our minds.  We feel that this website may be a ray of hope as last night I read 3 postings from parents that have experienced something similar with their children but no follow up was ever given.  I sent messages to these individuals to learn about their experiences; however, I'm not sure my efforts will be successful as these postings were written several years ago.  Does anyone have any other thoughts?  

[TMac78]

I just took my 8 month old son to the pediatrician after having the same exact experience.  It's as if I could have written your post. Sunday night was the second time that it happened and my husband and I were completely freaked out.  If you learn any more please let me know and I will do the same...we are just starting to attempt to figure things out here.

[TMac78]

I just took my 8 month old son to the pediatrician after having the same exact experience.  It's as if I could have written your post. Sunday night was the second time that it happened and my husband and I were completely freaked out.  If you learn any more please let me know and I will do the same...we are just starting to attempt to figure things out here.

[KatEyes]

I'm sure you want to leave no stone unturned in seeking an understanding of what's happening with your baby girl. It's what mothers do. It is of some comfort that she has seen a number of specialists.

During the sleep study, did she have any of the episodes you describe? I wasn't clear on if it's every night or occassionally.  If she did not, then they didn't get a full picture of her sleep. If she did, maybe you can ask the doctor to review the data collected at the specific times any episodes occurred.

Reflux would be suspect. Ask your doctor if raising the head of her mattress just a bit would help and which side it would be best for her to sleep on. I want to say left but not sure.

As far as obstructive sleep apnea, it's not always caused by enlarged tonsils. Sometimes the throat structure is small or the muscle tone lax. Then there's central sleep apnea, where the signal to breathe isn't properly conveyed from the brain to the mechanisms that cause breathing. Again, if she had any episodes during the study, they would have seen these.

Maybe you'd feel better if your doctor ordered an overnight recording oximetry for a few nights till you were sure it was on during some episodes. Also, I know there are apnea monitors for babies but I don't know much about them or if they are feasible in your case. Disrupted sleep if it happens regularly is not a good thing, but the greater concern would be if her oxygen level remains normal. If you can be sure that's happening, hopefully you can get relax and get some sleep yourself while you're waiting to figure this out. Best wishes.