When it comes to baby and toddler sleep there is such a wide variation of what may be considered ‘normal.’ Night waking, while exhausting, is actually so normal and common in the early years and may not be anything to be concerned about. This is especially true when a baby or toddler is going through a growth spurt, developmental burst, a sleep ‘regression,’ teething, separation anxiety, or sickness. However, if your baby is exhibiting a pattern of hourly wakes, meaning they are waking up almost every hour or two, for most of the night, or all night long, is restless, and/or needs lots of time and support to resettle back to sleep, it may be a indicative of underlying sleep red flags related to sleep disordered breathing.
What is Sleep Disordered Breathing (SDB)?
Sleep Disordered Breathing (SDB) is a term that encompasses a range of breathing difficulties that occur during sleep. It typically involves interruptions or irregularities in the normal breathing pattern, which can affect the flow of air in and out of the respiratory system. SDB is inclusive of primary snoring, Obstructive Sleep Apnea (OSA) as well as Upper Airway Resistance Syndrome (UARS).
Disruptions in sleep can lead to reduced oxygen levels in the bloodstream, fragmented sleep, and potential health risks, making it essential to identify and address these issues, particularly in infants and young children. This is why it is important to consider the quality of a child’s sleep and not just the number of hours they’re sleeping through the night.
Below you will see daytime and nighttime signs of SDB. Many are so common that they are now normalized. But please know none of these signs are normal. If your child is exhibiting one or more symptoms, they may have SDB.
Daytime Red Flags of Sleep Disordered Breathing
- Daytime sleepiness
- Dark circles under the eyes
- Waking with dry and/or cracked lips
- Mouth breathing
- Low tongue posture
- Oral habits such as thumb sucking
- Attention/concentration difficulties
- Learning challenges
Nighttime Red Flags of Sleep Disordered Breathing
- Mouth breathing
- Low tongue posture
- Snoring and/or Noisy breathing
- Gasping or pauses in breathing during sleep
- Sleeping in funky positions such as on their belly with bum tucked in the air, on their side or back with neck arched back and/or tilted upwards
- Need for sucking, all night long. This includes nursing, pacifier use, and thumb sucking
- Restless tossing and turning all night
- Frequent night sweats
- Teeth clenching/grinding
- Bedwetting
Want to learn more about the impacts of SDB and sleep? Checkout these video lectures on pediatric sleep and breathing from Dr. Soroush Zaghi, an ENT, who specializes in airway, sleep, and tongue ties.
Next steps if you suspect your child has SDB?
Sleep quality affects not only your child’s sleep but also their overall health and well being. There’s so much we can do in the early years to help prevent SDB or sleep apnea from developing. If you have a baby or toddler 3 years old or younger, scheduling an evaluation with a Speech-Language Pathologist (that’s me!) or Occupational Therapist who specializes in oral motor, feeding is recommended. If your child is 4+ years old, then working with a Myofunctional Therapist is recommended.
You may also need an evaluation with an airway centric ENT or Pediatric Dentist to assess the airway and rule out and/or address potential airway obstruction.
The following directories may help you find a preferred provider in your area:
Getting an evaluation is the first step in helping you identify and address the root cause of the symptoms your child is experiencing.
