Health Encyclopedia

Breathing - slowed or stopped

Definition

Breathing that slows down or stops from any cause is called apnea. Apnea can come once in a while and be temporary. This can occur with obstructive sleep apnea, for example. Prolonged apnea means a person has stopped breathing. This is also called respiratory arrest when the heart is still active. Prolonged apnea accompanied by lack of any cardiac activity and a patient who is not responsive is called cardiac arrest.

Alternative Names

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

Considerations

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

If a person with any type of apnea turns blue, has a seizure, becomes limp, remains drowsy, or is unconscious, immediately seek medical attention and call 911.

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 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:

Common causes of apnea in adults include:

Asthma or other lung diseases
Cardiac arrest
Choking
Drug overdose, especially drugs such as alcohol, narcotic painkillers, barbiturates, anesthetics, and other depressants (See also: Drug abuse first aid)
Obstructive sleep apnea

Other causes of apnea include:

Head or brain-stem injury
Irregular heartbeat (arrhythmias)
Metabolic disorders
Near-drowning
Nervous system disorders

Call your health care provider if

If a person has stopped breathing, call for emergency help and perform CPR (if you know how). When in a public place, look for an Automated External Defibrillator (AED) and follow the directions.

What to expect at your health care provider's office

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

Once the patient is stable, the doctor will do a physical exam and ask questions about the person's medical history. Questions may include:

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

The doctor will listen to the person's heart sounds and breath sounds. Diagnostic tests may be performed. They include:

Arterial blood gas
Chest x-ray
ECG
Other blood tests

References

Marx J, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2006.

Fleisher KE, Krieger AC. Current trends in the treatment of obstructive sleep apnea. J Oral Maxillofac Surg. 2007:65(10):2056-2068.

Review Date:2/19/2008
Reviewed By:John E. Duldner, Jr., MD, MS, Assistant Professor of Emergency Medicine, Director of Research, Department of Emergency Medicine, Akron General Medical Center and Northeastern Ohio Universities College of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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