Sudden Infant Death Syndrome & Obstructive Sleep Apnea

I recently stumbled upon a handful of studies about sudden infant death syndrome (SIDS) in a book on sleep apnea by Dr. Allan Pack. SIDS is a tragic condition where an infant dies suddenly in the first year of life or no apparent reason. Apparent life threatening events (ALTEs, or near-miss SIDS) are episodes then a child stops breathing, but comes back to life. Not too surprisingly, Dr. Christian Guilleminault (who published the original paper on upper airway resistance syndrome, and the link between sleep apnea and cluster headaches and sleep walking) and colleagues reported that in 3/5 families of children with SIDS or near-miss SIDS, parents and grandparents had elevated AHIs and excessive sleepiness. All seven children in this study with near-miss SIDS were found to have obstructive sleep apnea at 12 months. 

In a follow-up study, Guilleminault followed 25 children with near-miss SIDS (by 4.5 months) in a group of 700 that required sleep studies for over one year. All 25 were found to have obstructive sleep apnea by age 5. Deray, et al found that loud snoring frequency in fathers of SIDS or near-miss SIDS children was over 2 times that of control. It was stated clearly that this is a subgroup of all children with SIDS, but my gut feeling is that it’s much bigger than they think it is.

I alluded to another study in a past post where breast-feeding was found to lower SIDS rates. I’ve presented evidence that bottle-feeding may increase the chances of developing obstructive sleep apnea. It’s interesting to note that the peak incidence of SIDS occurs around 4-6 months. This is also the time that the infant’s voice box descends and separates away from the soft palate. This transitional period can be a dangerous time for infants, as they go from obligate nasal breathers (when they can suckle and breathe in parallel) to nasal and mouth breathers. 

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