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Updated: Feb 16, 2026

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
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Why is a prone sleeping position dangerous for certain infants?

Roger W Byard1, Fiona Bright2, Robert Vink3

  • 1School of Medicine, The University of Adelaide, Level 6 Medical School North Building, Frome Road, Adelaide, SA, 5005, Australia. roger.byard@sa.gov.au.

Forensic Science, Medicine, and Pathology
|December 16, 2017
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Summary

The prone sleeping position increases the risk of sudden infant death syndrome (SIDS). A deficit in substance P, crucial for head and neck movement control, may prevent infants from moving away from dangerous sleep environments.

Keywords:
Head and neck movementProne positionSIDSSubstance P

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Area of Science:

  • Neurology
  • Pediatrics
  • Sleep Medicine

Background:

  • The prone sleeping position is a known risk factor for sudden infant death syndrome (SIDS).
  • Previous theories implicated suffocation, rebreathing, or impaired arousal responses.
  • The exact physiological mechanisms underlying SIDS risk in the prone position remain incompletely understood.

Purpose of the Study:

  • To investigate potential neurobiological factors contributing to SIDS risk in infants sleeping prone.
  • To explore the role of substance P in the olivo-cerebellar complex in SIDS pathophysiology.

Main Methods:

  • Comparative analysis of substance P levels in the inferior olivo-cerebellar complex of SIDS infants versus controls.
  • Review of existing literature on proposed SIDS mechanisms and neurodevelopmental factors.

Main Results:

  • Significant reduction in substance P was observed in the inferior olivo-cerebellar complex of SIDS infants.
  • Substance P is critical for integrating sensory and motor information for head and neck movement control.

Conclusions:

  • A deficit in substance P may impair an infant's ability to reposition themselves when facing a hazardous sleep environment.
  • This neurochemical deficit offers a potential explanation for SIDS occurrence in the prone sleeping position.