Chapter 47 Reducing the risk of sudden infant death

Publisher Summary Prevention campaigns to avoid risk factors for the occurrence of sudden infant deaths (SID) during sleep have led to a significant decrease in the number of infants dying suddenly and unexpectedly during sleep. This chapter suggests a model for these underlying mechanisms responsible for SID and address the major challenges facing researchers in this field. During sleep SID has significantly more frequent obstructive apneas, less body movements, more sympathetic control of the heart rate, a desynchronized relation between sympathetic and vagal cardiac controls by the end of the night, and a decreased propensity to arouse from sleep. The respiratory and cardiac characteristics that would be found in the future SIDS victims could be related to an increased susceptibility to respiratory and cardiac dysregulations during sleep. These findings could represent a delay in maturation of vital control mechanisms in the infants at risk of SID. The decreased arousability could reveal a lesser propensity for these infants to arouse and autoresuscitate in the case of an acute respiratory or circulatory failure. These neurophysiological findings could result from postmortem findings within the victims' brain-stem, such as abnormally frequent occurrences of brain-stem gliosis, cellular apoptosis, or changes in receptor functions.