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What is the mechanism of sudden infant deaths associated with co-sleeping?

What is the mechanism of sudden infant deaths associated with co-sleeping?

N Z Med J. 2009;122(1307):69-75

Authors: McIntosh CG, Tonkin SL, Gunn AJ

The risk of Sudden Infant Death Syndrome (SIDS) has fallen dramatically in the "Back to Sleep" era; however, half the cases now occur when the infant has been sleeping in bed with another person. Despite the association of SIDS with co-sleeping, parents are receiving mixed messages. It is often presumed that co-sleeping deaths are due to 'overlaying', when the adult rolls on top of the baby, stopping baby from breathing. We examine research that shows that it is not necessary to cover the face, or squash the body of a baby to restrict or prevent breathing and cause oxygen deprivation. At birth, the temporo-mandibular joint is not yet fully formed, and thus the jaw can be easily displaced upwards and backwards pushing the tongue into the upper airway to form a partial or complete block of the airway. Indeed, this can happen with firm flexion of the infant's head so that the chin pushes against its own chest. Further research is needed, but on present evidence, all parents should be advised to sleep their baby in a cot or similar next to their parent's bed, until baby is at least 6 months of age.

PMID: 20148046 [PubMed - indexed for MEDLINE]

Sudden infant death and co-sleeping: stronger warning needed.

Sudden infant death and co-sleeping: stronger warning needed.

N Z Med J. 2009;122(1307):6-9

Authors: Mitchell EA

PMID: 20148039 [PubMed - indexed for MEDLINE]

A comparison of actigraphy and parental report of sleep habits in typically developing children aged 6 to 11 years.

A comparison of actigraphy and parental report of sleep habits in typically developing children aged 6 to 11 years.

Behav Sleep Med. 2010;8(1):16-27

Authors: Holley S, Hill CM, Stevenson J

There are limited published data comparing the information provided by parental reports of sleep habits with actigraphic information. This study compares parental report of sleep habits using the Children's Sleep Habits Questionnaire with actigraphic data in 91 typically developing children aged 6 to 11 years. The study found that sleep duration (as measured using actigraphy [ACT]) was longer in children whose parents rated their child as having enough sleep. Parental reports of night wakings did not correspond with ACT measures of night wakings. The findings show that ACT and parental reports provide differing, but complimentary, information about a child's sleep habits.

PMID: 20043246 [PubMed - indexed for MEDLINE]

Effects of dexmedetomidine sedation on the EEG in children.

Effects of dexmedetomidine sedation on the EEG in children.

Paediatr Anaesth. 2009 Dec;19(12):1175-83

Authors: Mason KP, O'Mahony E, Zurakowski D, Libenson MH

OBJECTIVES: To examine the effects of dexmedetomidine sedation on EEG background and epileptiform activity in children, comparing it to natural sleep. AIM: To provide quantitative and qualitative descriptions of the effect of dexmedetomidine sedation on the EEG of children. BACKGROUND: Children with intractable epilepsy admitted for surgery undergo 5 days of continuous EEG monitoring as well as nuclear medicine imaging studies with dexmedetomidine for sedation. Continuous EEG monitoring of each child during both natural sleep and dexmedetomidine-induced sedation provides a unique opportunity to evaluate the effects of dexmedetomidine on the EEG of children. MATERIALS/METHODS: Sixteen children undergoing dexmedetomidine sedation for nuclear medicine studies and simultaneous continuous EEG monitoring were studied. EEG segments during sedation were compared to samples of naturally occurring stage II sleep from the same child. Standard visual EEG analysis, quantification of delta, theta, alpha, beta, and total RMS power, number and location of spike foci, and frequency of spike activity were compared. RESULTS: The EEG during dexmedetomidine sedation resembled stage II sleep. During sedation, statistically significant increases in power of 16% for theta (P = 0.01), 21% for alpha (P = 0.03), and 40% for beta (P < 0.01) were observed, but not for delta (P = 0.63) or total EEG power (P = 0.61). Spike frequency increased by 47% during sedation but no new spike foci or seizures were observed. CONCLUSION: Dexmedetomidine sedation elicited an EEG pattern similar to that of Stage II sleep with modest increases in theta, alpha, and beta activity. Dexmedetomidine does not hinder interpretation of the EEG, suggesting that it may be a uniquely useful agent for EEG sedation in children.

PMID: 20017865 [PubMed - indexed for MEDLINE]

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IPSA Meeting 3-5 December 2010

Joint meeting with Pediatric Sleep Medicine Conference

3-5 December 2010. SAVE THE DATE!!!