PubMed · 8178159
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T G Keens, S L Ward. 1994-05-20. SIDS research.. https://doi.org/10.1126/science.8178159
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OBJECTIVE: To evaluate the influence of ambient temperature on infant's sleep and cardiorespiratory parameters during sleep. PATIENTS AND METHOD: 20 healthy infants with a median age of 11.5 weeks (range 7 to 18 weeks) were recorded polygraphically for one night. They were exposed to 3 different ambient temperatures (20 degrees C-25 degrees C-30 degrees C). Ambient and core temperatures were measured throughout the procedure. RESULTS: Influence of ambient temperature was seen in: RESPIRATORY PARAMETERS: The frequency of central apneas increased significantly with increasing temperatures in REM sleep, but not in NREM sleep. HEART RATE (HR) PARAMETERS AND HR SPECTRAL ANALYSIS: Elevation of temperature was characterized by significantly higher basal HR, shorter RR intervals, and lower parasympathetic activity in REM and NREM sleep. SATURATION IN OXYGEN: During total sleep time, rise in temperature induced a decrease in basal oxygen saturation. During REM sleep, a greater frequency of oxygen saturation drops was associated with central apneas. CORE TEMPERATURE: With increasing ambient temperature, the rise of rectal temperature was mild. Despite this lack of significant increase, similar results were found when sleep and cardiorespiratory parameters were evaluated according to rectal temperatures. CONCLUSION: Changes in ambient temperatures associated with mild increases in body temperature significantly modified cardiorespiratory parameters and autonomic controls in healthy infants. The changes associated with increases in temperature were mainly seen during REM sleep.
The description of an association between central apneas and the sudden infant death syndrome (SIDS) by Steinschneider et al. in 1972 was followed by a sharp rise of polygraphic studies. The hope to use these as a screening method for an increased risk of SIDS could subsequently not be confirmed by prospective studies. Pathological alterations, such as obstructive apneas and hypoxemias, however, seem to have prognostical relevance. They thus represent a focus of current research even though being unable as well to reliably predict a predisposition to SIDS for an individual subject. Instead of being used as a diagnostic tool for SIDS, polygraphic studies have nowadays acquired an accepted role in the investigation of certain physical symptoms and signs such as unexplained 'apparent life threatening events' (ALTE) or cyanotic attacks. Basic technical requirements for a polygraphic laboratory include facilities to record thoracic/abdominal respiration, nasal air flow, ECG/heart rate, oxygen saturation, and to classify different stages of sleep. Registration of additional parameters (EEG, breath sounds, video etc.) is optional, but may prove helpful to arrive at an appropriate diagnosis. Recently, Austrian and German centres have been trying in cooperation to standardize performance conditions and evaluation criteria for polygraphic measurements in pediatric patients under the guidance of the German Association for Sleep Medicine, Pediatric Workgroup. Their aim is to establish common guidelines for the diagnosis and treatment of sleep and arousal disorders in infancy and childhood.