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Arousal from sleep in infants is impaired following an infection
Rosemary S C Horne1, Andrew Osborne, Jessica Vitkovic
1Department of Paediatrics, Monash University, Wellington Road, Victoria, Clayton, Australia. rosemary.horne@med.monash.edu.au
Insights
Recent infant infections impair arousal responses during sleep. This reduced arousability may explain the increased risk of Sudden Infant Death Syndrome (SIDS) following illness.
Area of Science:
- Pediatrics
- Sleep Medicine
- Neonatology
Background:
- Sudden Infant Death Syndrome (SIDS) is a leading cause of infant mortality.
- Previous research suggests a correlation between recent infections and increased SIDS risk.
- The physiological mechanisms linking infection and SIDS remain unclear.
Purpose of the Study:
- To investigate the impact of recent infection on infant arousal responses during sleep.
- To compare arousal thresholds in infected infants before and after recovery.
- To compare arousal thresholds in infected infants with healthy controls.
Main Methods:
- Polysomnography was used to measure arousal thresholds in term infants.
- Air-jet stimulation was applied to the nares during active sleep (AS) and quiet sleep (QS).
- Arousal thresholds were assessed in infected infants pre-discharge and post-recovery, and in age-matched controls.
Main Results:
- Arousal thresholds in quiet sleep (QS) were significantly elevated in infected infants on discharge day compared to post-recovery.
- No significant differences in arousal thresholds were observed between studies in the control group.
- Impaired arousability from QS was evident in infants immediately following infection.
Conclusions:
- Recent infections can impair an infant's ability to arouse from quiet sleep.
- This diminished arousability following infection may contribute to the elevated SIDS risk.
- Further research is warranted to elucidate the precise mechanisms involved.
Abstract:
Numerous studies have postulated a link between recent infection and Sudden Infant Death Syndrome (SIDS). In this study we contrasted arousal responses from sleep in infants on the day of discharge from hospital following an infection with those when fully recovered and also with well age-matched control infants. Thirteen term infants comprised the infection group and nine well infants acted as age-matched controls. All infants were studied using daytime polysomnography and multiple measurements of arousal threshold (cm H(2)O) in response to air-jet stimulation applied alternately to the nares were made in both active sleep (AS) and quiet sleep (QS). All infants were studied on two occasions: firstly, immediately before discharge from the Paediatric ward, and secondly, 10-15 days later when they were completely well in the case of the infection group.Arousal thresholds in QS in the infection group were significantly elevated on the day of discharge (262 +/- 48 cm H(2)O) compared with 10-15 days later (205 +/- 31 cm H(2)O, p<0.05). Thresholds in the control group were not different between studies. This study provides evidence that arousability from QS is impaired following an infection and we postulate that this may explain the increased risk for SIDS following infection observed in previous studies.
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