A Spring of Joy

Once a baby is delivered, there are new and important matters to address, such as breastfeeding, newborn screening tests, and sleeping safety, so that the baby has the best chance to develop normally. Also, a newborn’s lungs and kidneys have not yet developed, and so he or she is much more vulnerable to breathing problems, including sleep apnea.

Sleep apnea is a common breathing problem, affecting one in five infants. Sleep apnea is characterized by the slow and irregular breathing that can be difficult to distinguish from an occasional yawn. As the mouth is opened and the airway opens (inhaled air enters), a person may find he or she can breath more quickly. If it happens several times a night, this is sleep apnea. Although most people do not experience these conditions on a regular basis, they can lead to serious health problems such as apnea (shortness of breath) and potentially serious respiratory problems.

Preventing sleep apnea

According to clinics like Children’s Physicians Raleigh, NC, for children with sleep apnea, sleeping without the need for a pacifier can help reduce the symptoms of the condition. In addition, sleep apnea prevention efforts should also focus on children with medical conditions, such as asthma, diabetes, and epilepsy. The American Academy of Pediatrics has developed a position statement on sleep apnea. It advises pediatricians and other health care providers to monitor their patients who are at risk for sleep apnea to monitor for sleep apnea episodes and to provide appropriate management to these patients to avoid continued problems. The American Academy of Pediatrics also advises that children with chronic obstructive pulmonary disease should be tested for obstructive sleep apnea. This testing is recommended every two years and should include at least the following five parameters: oxygen saturation (SOS), inbreath volume (IV), ventilation (V), tidal volume (T) and airflow rate (A). Most importantly, the tests should be done in the morning (before bedtime).

A number of studies have explored the effects of pacifier use on children with sleep apnea. This information has been used to develop recommendations for the use of pacifiers on children with sleep apnea. A study of 50 patients with COPD (which included 30 children with moderate to severe sleep apnea) showed that pacifier use resulted in a significant improvement in apnea-hypopnea index, a better sleep efficiency (SLE) score, a significantly greater number of awakenings (33%) and fewer apneas (15%). A comparison of pacifier use with no pacifier use showed no significant difference in apnea-hypopnea index, a better sleep efficiency (SLE) score or fewer apneas. In another study, 55 children with moderate to severe sleep apnea underwent the Sleep Evaluation Test, a standardized measurement of sleep quality (SETF), and were randomly assigned to receive pacifier therapy with or without no pacifier use for an average of 13.3 months. After 12 months, no significant difference in sleep quality between pacifier therapy and no pacifier therapy was found.

A study of 40 children with moderate to severe sleep apnea showed that with or without a pacifier, no significant effect on sleep apnea was observed.

The use of a pacifier in the absence of an associated need for artificial ventilation is unlikely to be of benefit in infants with significant sleep apnea, since the pacifier has little or no effect on airway, airway function, respiratory rate or gas exchange.