Cerebrospinal Fluid and Plasma Beta-Endorphin Concentrations in Prolonged Infant Apnea (Near-Miss Sudden Infant Death Syndrome)

In Reply.— Harpey and Renault postulate a relationship between the uvula, obstructive sleep apnea, and sudden infant death syndrome. Although I believe that obstructive sleep apnea syndrome may be one of the mechanisms leading to sudden infant death syndrome, this speculation is extremely controversial. I do concur with Harpey and Renault that obstructive sleep apnea can trigger esophageal reflux. A segment from a sleep recording of a 9-week-old, full-term infant with near-miss sudden infant death syndrome is presented in the Figure.

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Arousal responses in near-miss sudden infant death syndrome and in normal infants

The Journal of Pediatrics ◽

10.1016/s0022-3476(82)80009-7 ◽

1982 ◽

Vol 101 (6) ◽

pp. 911-917 ◽

Cited By ~ 113

Author(s):

Kristine McCulloch ◽

Robert T. Brouillette ◽

Anthony J. Guzzetta ◽

Carl E. Hunt

Keyword(s):

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

Near Miss ◽

Sudden Infant

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Mixed and Obstructive Sleep Apnea and Near Miss for Sudden Infant Death Syndrome: 2. Comparison of Near Miss and Normal Control Infants by Age

PEDIATRICS ◽

10.1542/peds.64.6.882 ◽

1979 ◽

Vol 64 (6) ◽

pp. 882-891 ◽

Cited By ~ 1

Author(s):

Christian Guilleminault ◽

Ronald Ariagno ◽

Rowena Korobkin ◽

Lynn Nagel ◽

Roger Baldwin ◽

...

Keyword(s):

Normal Control ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Periodic Breathing ◽

Sudden Infant Death ◽

Near Miss ◽

Sudden Infant ◽

Obstructive Apnea ◽

Respiratory Events ◽

Obstructive Sleep

Twenty-nine full-term near miss for sudden infant death syndrome (SIDS) and 30 normal control infants underwent 24-hour polygraphic monitoring. Several types of respiratory events during sleep (eg, central, mixed, and obstructive apnea, periodic breathing) were defined and tabulated. Analysis of these respiratory variables and comparison of groups of near miss and control infants indicated that between 3 weeks and 4½ months of age only one variable was consistently different at a statistically significant level: the number of mixed and obstructive apnea 3 seconds during total sleep time. This study also showed an increase in mixed and obstructive respiratory events during sleep at 6 weeks of age in control as well as in near miss infants.

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Incidence of Apnea in Siblings of Sudden Infant Death Syndrome Victims Studied at Home

PEDIATRICS ◽

10.1542/peds.70.1.128 ◽

1982 ◽

Vol 70 (1) ◽

pp. 128-131

Author(s):

Dorothy H. Kelly ◽

Joseph Twanmoh ◽

Daniel C. Shannon

Keyword(s):

Sudden Infant Death Syndrome ◽

Infant Death ◽

Chronic Hypoxia ◽

Breathing Pattern ◽

Respiratory Control ◽

Periodic Breathing ◽

Sudden Infant Death ◽

Near Miss ◽

Sudden Infant ◽

Sibling Group

Victims of sudden infant death syndrome (SIDS) have been shown to have pathologic abnormalities consistent with chronic hypoxia.1-7 Two groups of infants at high risk of dying of SIDS, near miss infants and subsequent siblings of SIDS victims, have been studied in attempts to demonstrate physiologic abnormalities that could account for these pathologic findings. Investigators have found abnormalities in breathing pattern and the respiratory control system in the former consisting of prolonged sleep apnea, excessive short apnea, periodic breathing, hypoventilation, and depressed response to hypercarbia.8-13 However, studies in the SIDS sibling group have demonstrated varying results of excessive periodic breathing in the home14 and decreased apnea in the laboratory.15

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