Apneic breathing is when a person’s breathing temporarily and involuntarily stops for any reason. It may occur in preterm infants or people with conditions, such as sleep apnea.

The type of apneic breathing a person has can depend on the cause and symptoms they exhibit. A 2021 study suggests that obstructive sleep apnea alone affects 26% of people between the ages of 30–70 living in the United States.

People may have periods of apneic breathing during sleep due to a blockage of their upper airways or a change in their breathing control. Apneic breathing may also occur in premature babies due to underdeveloped breathing control.

This article will explain the different types of apneic breathing, who is most at risk, and how doctors diagnose and treat this condition.

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Sleep apnea is a condition that affects a person’s breathing during sleep, causing their breathing cycles to stop and start. The National Heart Lung and Blood Institute (NHLBI) highlight two different types of sleep apnea:

  • Obstructive sleep apnea: This is the most common form of sleep apnea. It occurs with an obstruction of the upper airways during sleep that can partly or completely block airflow.
  • Central sleep apnea: This occurs when the brain does not send signals that a person’s body needs to breathe.

However, apneic breathing does not only occur when a person is sleeping.

Infant apnea is another condition characterized by periods when breathing temporarily stops. Apnea is common in preterm infants but can happen at any age.

In preterm infants, apnea lasts for at least 20 seconds. Infants between the ages of 2–4 weeks may experience short cycles of apnea lasting for 5–10 seconds, also known as periodic breathing. This should stop by itself by 6 months of age.

What does an apneic event mean?

An apneic event, or episode, is an involuntary pause in breathing, which may occur with sleep apnea or other types of apneic breathing.

A person’s breathing may stop for 20 seconds or longer. Apneic events may prevent the body from taking in enough oxygen.

The symptoms a person shows can depend on the type of apneic breathing they have. Symptoms of sleep apnea include:

  • frequent, loud snoring
  • breathing that starts and stops during sleep
  • gasping for air while sleeping
  • feeling tired and sleepy while awake, which may affect concentration and focus
  • dry mouth
  • headaches
  • low sex drive or sexual dysfunction
  • waking up frequently to urinate

According to the NHLBI, sleep apnea symptoms in children may also include bedwetting, being overactive, difficulty paying attention, and worsening asthma.

Symptoms of apnea in infants may include:

  • breathing which stops for at least 20 seconds
  • an abnormal heart rhythm
  • bluish color to the skin
  • pallor
  • decreased muscle tone

Obstructive sleep apnea occurs when a person’s upper airways become blocked, reducing or stopping airflow during sleep. For instance, if a person’s tongue falls back toward the throat, blocking their airway.

Central sleep apnea happens due to an issue with the brain signals that control a person’s airway and chest muscles during sleep. The NHLBI highlights certain health conditions that can raise the risk of this, including:

Traveling to high altitudes of more than 6,000 feet can cause symptoms of apneic breathing due to low oxygen levels. This may last for a few weeks post-travel.

In infants, premature birth may cause apneic breathing due to an underdeveloped respiratory system and breathing control. Other causes of infant apnea may include:

The NHLBI highlights several risk factors for apneic breathing, including:

  • Age: Older age increases the risk of sleep apnea. With age, fatty tissue may build up around the neck and tongue, which increases the risk of breathing difficulties during sleep. Age may also change how the brain controls breathing during sleep.
  • Genetics: Inherited genes that affect the size and shape of the head and upper airways may increase the risk of sleep apnea. Down syndrome, congenital central hypoventilation syndrome, and cleft lip and palate are also risk factors.
  • Sex: Sleep apnea is more common in males. It is also more likely for males to have more severe sleep apnea at a younger age than females.
  • Hormonal changes: Health conditions that alter hormone levels can increase the risk of sleep apnea.
  • Heart or kidney failure: Heart or kidney failure can lead to a buildup of fluid in the neck, which can block a person’s airways.
  • Large tonsils, tongue, or a thick neck: Tongue position and thickness, a thick neck, or large tonsils may all increase the risk of narrow or blocked upper airways.
  • Lifestyle habits: Smoking and alcohol can affect the upper airways and alter how the brain controls breathing during sleep.
  • Obesity: Obesity can cause fat deposits around the neck that can block the airways.
  • Opioid use: Long-term use of opioids or an opioid use disorder can affect how the brain regulates sleep.
  • Health conditions: Hormone levels and certain health conditions, including stroke and myasthenia gravis, can alter how the brain controls breathing.
  • Premature birth: Infants born before 37 weeks have an increased risk of sleep apnea, although this risk usually decreases as they age.

To diagnose apneic breathing and its underlying cause, doctors may examine a person’s medical history and complete a physical examination.

For some people, they will suggest a sleep study. This records brain waves and monitors a person’s heart rate, breathing, and oxygen levels during sleep. Alternatively, they may ask people to keep a sleep diary to track their symptoms.

A doctor may also do blood tests to check for abnormal hormone levels, which may be causing apnea, and pelvic ultrasounds, to test for polycystic ovary syndrome.

For infants, a doctor may carry out:

  • a full medical and family history
  • a physical examination
  • a complete blood count
  • tests to measure calcium, electrolyte, and glucose levels
  • blood and urine tests to check for any infections
  • an electrocardiogram to check heart rhythm

Learn more about how doctors may test for sleep apnea here.

Treatments for apneic breathing may depend on the type and underlying cause. Treatments may include:

  • Lifestyle changes: Achieving and maintaining a moderate body mass index (BMI), getting regular exercise, and adopting healthy sleeping habits may help, as well as limiting alcohol and quitting smoking.
  • Sleeping on the side: Sleeping on the side instead of the back may help keep the airways open.
  • Breathing devices: People may use a continuous positive airway pressure (CPAP) or auto-adjusting positive airway pressure (APAP) machine to deliver air pressure to the throat and keep the airways open.
  • Oral devices: A person may wear a specialized device in their mouth to keep their airways open. These devices may hold the jaw or tongue in certain positions to prevent airway blockages.
  • Mouth and facial exercises: Physical therapy exercises for the mouth and facial muscles may help alter tongue position and strengthen muscles in the face and upper airways.
  • Surgery: Surgery may include removing the tonsils and adenoids, implanting a device to help keep the airways open, removing soft tissue from the mouth and throat, or adjusting the jaw to enlarge the upper airways.

Apneic breathing is a temporary and involuntary pause in breathing that can occur during sleep. Apnea may affect infants, children, and adults.

Treatment can depend on the underlying cause but may include lifestyle changes, breathing devices, or facial and muscle therapy.