Sleep apnea in 3 year old?

[mshanson3121]

So we have a  DD, 3 years 4 months, that has had sleep problems basically forever. She does have ASD and we know that sleep issues can go hand in hand with that, however, something happened last night that has made me wonder if apnea might be the cause of her night wakings:

She woke up (as usual), and came downstairs to our bed. Fell back asleep. I woke up a while later, not sure why and looked over at her. Not sure what made me look, but I could not see her chest/belly moving at all (she was flat on her back). Figured it was from her thick jammies. Put my hand on her belly, I could feel nothing, no movement at all. Took my hand off tried again... and again... nothing. Started calling her name, put my finger under her nose to see if I could feel her breathing, nothing. Shouted my husband's name to wake him up, put my hand on her chest, nothing. I gave her a little shake, and she kind of startled, took a deep sigh, and rolled over, breathing, though shallowly.

I'm not sure how long the whole thing lasted. 10 seconds maybe? More? I don't know. I'm fairly certain she wasn't breathing as I checked several times. I've never seen this happen before. I mean, sometimes when she sleeps she'll hold her breath for a few seconds (2-3 seconds), and sometimes her heart will beat erratically, skip a beat, but nothing ever like this. She isn't a great sleeper as I mentioned. She wakes up every night. Sometimes once, sometimes three times. You never know. And when she does sleep she's often very restless.

Is there any chance she has apnea,  or is it more likely it was just a fluke? We've just always chalked up the sleeping issues to her ASD, but again, I've never seen her stop breathing before like last night. She does snore sometimes, but not always.

[Paderla Anitha, DNB]

Hi, she could have been tired and sleeping well. Usually after the ‘cessation of breathing’ due to sleep apnea, people are awakened from sleep to take a deep breath.

When a person sleeps the airways are usually patent allowing normal passage for air entry. The upper airway that is at the region of the tongue and the soft palate is the most compliant (soft) part. So, this is liable to collapse and cause airway obstruction in Obstructive Sleep Apnea. As the airway collapses the lungs do not have air entry leading to deoxygenation (decreased oxygen) of blood and the person wakes up. This period of non entry of air is called ‘Apnea’ and the waking up is called an ‘Arousal’.

But Snoring by itself indicates a narrowed air passages. For this she can try to sleep sideways and if any nasal blocks try to keep them patent with OTC nasal decongestants. If her snoring worsens or if her sleep is restless then consult her doctor for an evaluation. Regards.

[Bhupinder Kaur, MD]

Hello,

I can understand your concern for your daughter. Breath holding spells are common in children and these may occur even during sleep. These are less likely to be related to her ASD. I suggest you to consult a sleep specialist and get a sleep study done for your daughter.  She may be having sleep apnea as well but this can be confirmed only after sleep study.


It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Bhupinder Kaur, MD]

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.