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Consequences of getting the head covered during sleep in infancy
1Department of Pediatrics, University Hospital of Bergen, Bergen, Norway.
Insights
Infants covered by bedding experience increased carbon dioxide (CO2) levels and physiological distress, especially when sleeping prone. Their limited ability to remove covers poses a risk, particularly for sudden infant death syndrome.
Area of Science:
- Pediatric Sleep Medicine
- Infant Safety
- Respiratory Physiology
Background:
- Sudden infant death syndrome (SIDS) is often associated with infants found under bedding.
- Understanding the physiological impact of head covering in infants is crucial for SIDS prevention.
Purpose of the Study:
- To investigate the effects of head covering with bedding on infant physiological responses during sleep.
- To assess carbon dioxide (CO2) accumulation around the face and infant behavior during prone and supine sleep positions.
Main Methods:
- Utilized computerized polysomnography and behavioral monitoring in 30 infants at 2.5 months and 23-25 infants at 5 months.
- Recorded sleep data during both prone and supine positions with and without head covering.
Main Results:
- Head covering led to significant CO2 accumulation, increased heart and respiratory rates, and elevated skin temperature.
- The prone position exacerbated CO2 levels and physiological stress compared to the supine position.
- Infants demonstrated a limited ability to remove head coverings, especially when in the prone position.
Conclusions:
- Head covering poses a risk of physiological distress to infants, particularly in the prone position.
- The inability of infants to remove bedding from their heads during prone sleep is a significant concern for SIDS risk.
Objective:
To study the consequences of getting the head covered by bedding (fiber quilt) on carbon dioxide (CO2) accumulation around the face, behavior, and physiologic responses during prone and supine sleep in infants to add understanding to why victims of sudden infant death syndrome are often found under the bedding. METHPDOLOGY: Of 33 healthy term, usually nonprone sleeping infants, behavior and computerized polysomnography were successfully recorded for 30 during prone and supine sleep at 21/2 months and for 23 prone and 25 supine at 5 months.
Results:
For both ages and body positions, covering the head resulted in significant CO2 accumulation around the face, fewer apneas (3 to 10 seconds), shorter duration of apneas after sighs, higher heart and respiratory rates, and peripheral skin temperature. Differences were generally greater at 21/2 than at 5 months. While covered, the prone position was associated with higher CO2 levels close to the face, slightly higher transcutaneous PCO2, and higher heart rates and peripheral skin temperatures than the supine position. In the supine position 23% were able to remove the cover from the head at 21/2 and 60% at 5 months, whereas only 1 infant of 5 months managed to remove the cover when prone.
Conclusions:
The observed responses are consistent with a potential for distress when the head is covered, particularly when placed prone. Probably most important with respect to sudden infant death syndrome is the infants' inability to remove the bedding from the head upon awakening from prone sleep.