Breathing - slowed or stopped

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Alternative names
Respiration slowed or stopped; Not breathing; Respiratory arrest; Apnea

Definition
Apnea means absence of spontaneous breathing from any cause. Apnea can be intermittent and temporary, as occurs with obstructive sleep apnea, or prolonged. Prolonged apnea is also called respiratory arrest.

Considerations

Prolonged apnea (respiratory arrest) is a life-threatening disorder that requires immediate medical attention and first aid.

Any episode of apnea, even a temporary one, in which a person turns blue, has a seizure, becomes limp, or remains drowsy or unconscious, requires prompt medical attention.

Apnea can occur for many different reasons. The most common causes of apnea in infants and small children are generally quite different from the most common causes in adults.

In infants and children, the most common cause of cardiac arrest (lack of an effective heartbeat) is a preceding respiratory arrest. In adults, the opposite usually occurs: cardiac arrest leads to respiratory arrest.

Common Causes

Common causes of apnea in infants and young children include:

• prematurity
  
• bronchiolitis or pneumonia
  
• foreign object aspiration or choking
  
• breath-holding spells
  
• seizures
  
• meningitis or encephalitis
  
• gastroesophageal reflux
  
• bronchospasm (asthma)

Common causes of apnea in adults include:

• obstructive sleep apnea
  
• choking
  
• drug overdose, especially drugs such as alcohol, narcotic analgesics, barbiturates, anesthetics, and other depressants (see drug abuse first aid)
  
• cardiac arrest

Other causes of apnea include:

• near-drowning
  
• head or brain-stem injury
  
• irregular heartbeat (arrhythmias)
  
• metabolic disorders
  
• nervous system disorders

Home Care

If a person has stopped breathing, emergency measures should be taken, and call for emergency help! Also see the information on CPR.

Call your health care provider if

If there is any interruption in spontaneous breathing, this is an emergency! Call 911 (or your local emergency number) and begin CPR if breathing has stopped.

What to expect at your health care provider’s office

CPR or other emergency measures will be provided in an emergency room or by an ambulance EMT (emergency medical technician).

Once the patient is in a stable state, the medical history will be obtained and a physical examination performed.

Medical history questions documenting absent breathing in detail may include:

• time pattern
  o Has this ever happened before?
  o How long did the event last?
  o Has the person had repeated, brief episodes of apnea?
  o Did the episode end with a sudden deep snorting breath?
  
• recent heath history
  o Has there been any recent history of an accident or injury?
  o Has the person been ill recently?
  
• other
  o Did the episode occur while awake or asleep?
  o Had there been any breathing difficulty before the breathing stopped?
  o What other symptoms are also present?
  o What medication does the person take?
  o Does the person use street drugs?

A general physical examination will be performed, including listening for heart sounds and breath sounds. The heart and lungs will be monitored. Diagnostic tests will be determined by the results of history and physical examination data.

Diagnostic tests that may be performed are:

• chest X-ray
  
• ECG
  
• arterial blood gas

After seeing your health care provider:
You may want to add a diagnosis related to apnea to your personal medical record.

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