Breathing - slowed or stopped
Respiration slowed or stopped; Not breathing; Respiratory arrest; ApneaBreathing that stops from any cause is called apnea. Slowed breathing is called bradypnea. Labored or difficult breathing is known as dyspnea.
Considerations
Apnea can come and go and be temporary. This can occur with obstructive sleep apnea, for example.
Prolonged apnea means a person has stopped breathing. If the heart is still active, the condition is known as respiratory arrest. This is a life-threatening event that requires immediate medical attention and first aid.
Prolonged apnea with no heart activity in a person who is not responsive is called cardiac (or cardiopulmonary) arrest. In infants and children, the most common cause of cardiac arrest is respiratory arrest. In adults, the opposite usually occurs, cardiac arrest most often leads to respiratory arrest.
Causes
Breathing difficulty can occur for many reasons. The most common causes of apnea in infants and small children are different from the most common causes in adults.
Common causes of breathing difficulties in infants and young children include:
- Asthma
Asthma
Asthma is a chronic disease that causes the airways of the lungs to swell and narrow. It leads to breathing difficulty such as wheezing, shortness o...
Read Article Now Book Mark Article - Bronchiolitis (inflammation and narrowing of the smaller breathing structures in the lungs)
Bronchiolitis
Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles). It is usually due to a viral infection....
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Choking
Non-fatal drowning means a person developed trouble breathing from being underwater or having their head underwater, and survived. If a person has be...
Read Article Now Book Mark Article - Encephalitis (brain inflammation and infection that affects vital brain functions)
Encephalitis
Encephalitis is irritation and swelling (inflammation) of the brain, most often due to infections.
Read Article Now Book Mark Article - Gastroesophageal reflux (heartburn)
Gastroesophageal reflux
Gastroesophageal reflux occurs when stomach contents leak backward from the stomach into the esophagus. This causes "spitting up" in infants....
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Holding one's breath
Some children have breath-holding spells. This is an involuntary stop in breathing that is not in the child's control.
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Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
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Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
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Premature birth
A premature infant is a baby born before 37 full weeks of gestation (more than 3 weeks before the due date).
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Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
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Common causes of breathing trouble (dyspnea) in adults include:
- Allergic reaction that causes tongue, throat, or other airway swelling
- Asthma or other lung diseases
- Cardiac arrest
- Choking
- Drug overdose, especially due to alcohol, narcotic painkillers, barbiturates, anesthetics, and other depressants
- Fluid in the lungs
- Heart attack
- Irregular heart beat
- Metabolic (body chemical, mineral, and acid-base) disorders
- Obstructive sleep apnea
Other causes of apnea include:
- Cardiac arrest
- Head injury or injury to the neck, mouth, and larynx (voice box)
Head injury
A head injury is any trauma to the scalp, skull, or brain. Head injury can be either closed or open (penetrating). A closed head injury means you rec...
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Near drowning
Non-fatal drowning means a person developed trouble breathing from being underwater or having their head underwater, and survived. If a person has be...
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- Injury to the chest wall, heart, or lungs
When to Contact a Medical Professional
Seek immediate medical attention or call your local emergency number (such as 911) if a person with any type of breathing problem:
- Becomes limp
- Has a seizure
- Is not alert (loses consciousness)
- Remains drowsy
- Turns blue
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.
CPR
CPR stands for cardiopulmonary resuscitation. It is an emergency life-saving procedure that is done when someone's breathing or heartbeat has stoppe...
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CPR or other emergency measures will be done in an emergency room or by an ambulance emergency medical technician (EMT) or paramedic.
Once the person is stable, the health care provider will do a physical exam, which includes listening to heart sounds and breath sounds.
Heart sounds
A heart murmur is a blowing, whooshing, or rasping sound heard during a heartbeat. The sound is caused by turbulent (rough) blood flow through the h...
Read Article Now Book Mark ArticleQuestions will be asked about the person's medical history and symptoms, including:
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 the person had a recent accident or injury?
- Has the person been ill recently?
- Was there any breathing difficulty before breathing stopped?
- What other symptoms have you noticed?
- What medicines does the person take?
- Does the person use street or recreational drugs?
Diagnostic tests and treatments that may be done include:
- Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
- Blood and urine tests
- Chest tube
- Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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- Defibrillation (electrical shock to the heart)
- ECG (electrocardiogram, or heart tracing)
- Fluids through a vein (intravenous or IV)
- Medicines to treat symptoms, including antidotes to reverse the effects of a poisoning or overdose
References
Easter JS. Pediatric resuscitation. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 158.
Haas NL, Kurz MC. Adult resuscitation. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 5.
Hartman ME, Cheifetz IM. Pediatric emergencies and resuscitation. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 81.
Review Date: 2/2/2023
Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.