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Published ahead of print on August 13, 2003, doi:10.1164/rccm.200301-134OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 11, December 2003, 1298-1303

A more recent version of this article appeared on December 1, 2003
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Submitted on February 4, 2003
Accepted on August 13, 2003

Incomplete arousal processes in infants with sudden death

Ineko Kato1, Patricia Franco2, Jose Groswasser3, Sonia Scaillet3, Igor Kelmanson4, Hajime Togari1, and Andre Kahn3*

1 Pediatrics, Nagoya City University Medical School, Nagoya, Japan, 2 Pediatric Sleep Unit, Neuropediatrics, Erasmus Hospital, Brussels, Belgium, 3 Pediatric Sleep Unit, University Children's Hospital Free University of Brussels, Brussels, Belgium, 4 Pediatrics, St. Petersburg State Pediatric Medical Academy, St. Petersburg, Russia

* To whom correspondence should be addressed. E-mail: akahn{at}ulb.ac.be.

Infants who became victims of Sudden Infant Death Syndrome (SIDS) arouse less from sleep than control infants. This study was conducted to determine the characteristics of arousal from sleep of infants who eventually died of SIDS. Sixteen infants were monitored some days or weeks before they died of SIDS. Their polygraphic sleep recordings were compared with those of matched control infants. Arousals were scored as subcortical activation (incomplete arousals), or cortical arousal (complete arousals). Cortical arousals were significantly less frequent in the future SIDS victims than in the control infants during both REM and NREM sleep (p = .039). The frequency (p = .017) and duration (p = .005) of subcortical activation were significantly greater in the SIDS than in the control infants during REM sleep. Compared to the control infants, the SIDS victims had more frequent subcortical activation in the first part of the night, between 9 pm and midnight (p = .038), and fewer cortical arousals during the latter part of the night, between 3 am and 6 am (p = .011). The present data are suggestive of incomplete arousal processes in infants who eventually died at a time they were presumed to have been asleep.
Key words: Sleep, Arousal, Death, SIDS, Apnea




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