Apnea is sometimes misunderstood to be a precursor of sudden infant death syndrome (SIDS). But children with apnea rarely die. And there is no evidence that a baby with sleep apnia is at greater risk for SIDS.
Layne Melzer awoke around 8 a.m. Jan. 6 and looked at his 6-week-old son, Shane, beside him. Most mornings, it was the baby who roused him at dawn with lusty yells for food, so Melzer was surprised to find Shane still asleep. Then he took a closer look. Shane's skin was dusky, and he did not seem to be breathing. Melzer jiggled him tentatively, but the baby did not rouse. His color was darker now. Bluish.
Yelling to his wife to call 911, Melzer grabbed Shane and shook him -- hard this time. The baby's eyes opened at one point, but his gaze was blank.
Frantically trying to recall resuscitation techniques, Melzer put his mouth over Shane's and puffed twice. Then he turned the baby over and slapped him on the back. He slapped him again, and then a third time. Suddenly Shane gulped for air and began to cry. A moment later, the rescue squad arrived.
The crisis, though, was far from over. By noon, Shane was admitted to Childrens Hospital of Orange County with a tentative diagnosis of severe apnea.
The term apnea comes from the Latin words a and pneuma, which means without air. Medically, it refers to pauses in breathing.
The main consequence of apnea is damage to the brain and heart because of repeated periods of inadequate oxygen. A baby with untreated apnea can, in later years, exhibit learning and behavioral problems, even cerebral palsy, associated with brain damage. Shane Melzer's problem was central apnea, exacerbated by a viral infection.
Shane's breathing pauses were found to be frequent, long and responsible for repeated episodes of bradycardia -- the medical term for an abnormally slow heart rate. He met all the criteria for a diagnosis of severe apnea. Two days after being admitted to CHOC, he was transferred to the intensive care unit.
He just got worse. At 3:30 the morning following his transfer, the Melzers were awakened by a call from a doctor in the unit. Shane's apnea was so bad that he now required the assistance of a respirator to survive, the doctor told them. But Shane was fortunate to be in a hospital with expertise in the treatment of apnea.
Shane's apnea has caused no more trouble. His breathing pauses have never been severe enough to trigger the monitor, his parents report, and in every other respect, he is thriving.
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