Abnormal Maturation of Sleep States in Infants with Aborted Sudden Infant Death Syndrome

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Abstract
Summary: The time spent in REM, quiet, and indeterminate sleep was computed in 13 aborted SIDS infants and compared to that spent in the same sleep states in 19 normal infants. Aborted sudden infant death syndrome (SIDS) infants were studied within a week of their aborted SIDS episode and subsequently at monthly intervals through the age of 4 months. Normal infants were studied at 1, 2, 3, and 4 months of age. Sleep staging was performed by two independent observers using electroencephalogram, electrooculogram, electromyogram and behavioral criteria. Although there was an increase in the percentage of time spent in quiet sleep with age in both normal and aborted SIDS infants, the significantly greater regression coefficients in normal infants (6.3 versus 2.9; P < 0.01) indicate that there are differences in the two groups and suggest a maturational abnormality or delay in sleep state distribution in aborted SIDS infants. Speculation: The results of this study suggest that the differences in sleep state distribution between aborted sudden infant death syndrome and normal infants share a common pathophysiologic alteration with the ventilatory and cardiac abnormalities reported by us elsewhere, perhaps involving the catecholaminergic system.

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