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Published on: December 22, 2016
Arterial oxygen saturation in infants at risk of sudden death: influence of sleeping position
C F Poets1, A Rudolph, K Neuber
1Department of Paediatric Pulmonology, Hannover Medical School, Germany.
Insights
Sleeping position did not significantly affect infant oxygen saturation, but prone sleeping was linked to more sleep time. Further investigation is needed for desaturations in prone sleeping, especially in SIDS cases.
Area of Science:
- Pediatrics
- Sleep Medicine
- Cardiorespiratory Physiology
Background:
- Sudden Infant Death Syndrome (SIDS) remains a concern, with sleeping position being a studied risk factor.
- Previous research has explored the link between infant sleeping position and cardiorespiratory parameters.
Purpose of the Study:
- To investigate the influence of sleeping position (prone vs. supine) on arterial oxygen saturation (SpO2) in infants at increased risk for SIDS.
- To analyze sleep time and the occurrence of desaturations in different sleeping positions.
Main Methods:
- Overnight polysomnography (breathing movements and ECG) in 43 high-risk infants (median age 2.4 months).
- Infants were randomly assigned to start in either their usual or opposite position, switching after 3.5 hours (each infant served as their own control).
- Analysis included sleep time, baseline SpO2, and the number/duration of desaturations (SpO2 ≤ 80%).
Main Results:
- Infants spent a significantly higher proportion of time asleep in the prone position (79%) compared to the supine position (70%).
- No significant difference was found in median baseline SpO2 between prone (98.8%) and supine (99.0%) positions.
- The total number of desaturations was similar between prone (96) and supine (95) positions.
Conclusions:
- Sleeping position does not appear to significantly impact baseline arterial oxygen saturation in infants at risk for SIDS.
- The prone position was associated with increased sleep time.
- A single SIDS case showed desaturations exclusively in the prone position, warranting further investigation into positional effects on oxygenation during sleep.
Abstract:
To study the possible influence of sleeping position on arterial oxygen saturation, measured by pulse oximetry (SpO2), 7-h overnight recordings of breathing movements and ECG were performed in 43 infants (median age 2.4 months, range 0.2-11 months) at increased risk of sudden infant death syndrome (SIDS). Infants were randomly allocated to start sleeping either in their usual sleeping position or in the opposite position. After 3.5 h, all infants were gently turned over. Thus, each infant served as their own control. Recordings were analysed for sleep time, baseline SpO2 (only during regular breathing), and the number and duration of desaturations (a decrease in SpO2 to < or = 80%). In the prone position, a significantly higher proportion of time was spent asleep (median 79% versus 70%; p < 0.05). Median baseline SpO2 was 98.8% (91.7-100%) in the prone and 99.0% (92.0-100%) in the supine position (ns). A total of 191 desaturations were found in 29 recordings; 96 in the prone and 95 in the supine position (ns). One infant subsequently died of SIDS while sleeping in the prone position. He had a relatively high number of desaturations (n = 12) which all occurred in the prone position. These results confirm earlier studies which could not find a significant influence of sleeping position on baseline oxygenation. The occurrence of desaturations in the prone position only in the infant who subsequently died requires further investigation.
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