Book contents
- Frontmatter
- Contents
- Dedication
- Acknowledgements
- Foreword
- 1 Sudden Infant Death Syndrome: Definitions
- 2 Sudden Infant Death Syndrome: An Overview
- 3 Sudden Unexplained Death in Childhood: An Overview
- 4 Sudden Infant Death Syndrome: History
- 5 Responding to Unexpected Child Deaths
- 6 The Role of Death Review Committees
- 7 Parental Perspectives
- 8 Parental Grief
- 9 Promoting Evidence-Based Public Health Recommendations to Support Reductions in Infant and Child Mortality: The Role of National Scientific Advisory Groups
- 10 Risk Factors and Theories
- 11 Shared Sleeping Surfaces and Dangerous Sleeping Environments
- 12 Preventive Strategies for Sudden Infant Death Syndrome
- 13 The Epidemiology of Sudden Infant Death Syndrome and Sudden Unexpected Infant Deaths: Diagnostic Shift and other Temporal Changes
- 14 Future Directions in Sudden Unexpected Death in Infancy Research
- 15 Observational Investigations from England: The CESDI and SWISS Studies
- 16 An Australian Perspective
- 17 A South African Perspective
- 18 A United Kingdom Perspective
- 19 A United States Perspective
- 20 A Scandinavian Perspective
- 21 Neonatal Monitoring: Prediction of Autonomic Regulation at 1 Month from Newborn Assessments
- 22 Autonomic Cardiorespiratory Physiology and Arousal of the Fetus and Infant
- 23 The Role of the Upper Airway in SIDS and Sudden Unexpected Infant Deaths and the Importance of External Airway-Protective Behaviors
- 24 The Autopsy and Pathology of Sudden Infant Death Syndrome
- 25 Natural Diseases Causing Sudden Death in Infancy and Early Childhood
- 26 Brainstem Neuropathology in Sudden Infant Death Syndrome
- 27 Sudden Infant Death Syndrome, Sleep, and the Physiology and Pathophysiology of the Respiratory Network
- 28 Neuropathology of Sudden Infant Death Syndrome: Hypothalamus
- 29 Abnormalities of the Hippocampus in Sudden and Unexpected Death in Early Life
- 30 Cytokines, Infection, and Immunity
- 31 The Genetics of Sudden Infant Death Syndrome
- 32 Biomarkers of Sudden Infant Death Syndrome (SIDS) Risk and SIDS Death
- 33 Animal Models: Illuminating the Pathogenesis of Sudden Infant Death Syndrome
22 - Autonomic Cardiorespiratory Physiology and Arousal of the Fetus and Infant
Published online by Cambridge University Press: 20 July 2018
- Frontmatter
- Contents
- Dedication
- Acknowledgements
- Foreword
- 1 Sudden Infant Death Syndrome: Definitions
- 2 Sudden Infant Death Syndrome: An Overview
- 3 Sudden Unexplained Death in Childhood: An Overview
- 4 Sudden Infant Death Syndrome: History
- 5 Responding to Unexpected Child Deaths
- 6 The Role of Death Review Committees
- 7 Parental Perspectives
- 8 Parental Grief
- 9 Promoting Evidence-Based Public Health Recommendations to Support Reductions in Infant and Child Mortality: The Role of National Scientific Advisory Groups
- 10 Risk Factors and Theories
- 11 Shared Sleeping Surfaces and Dangerous Sleeping Environments
- 12 Preventive Strategies for Sudden Infant Death Syndrome
- 13 The Epidemiology of Sudden Infant Death Syndrome and Sudden Unexpected Infant Deaths: Diagnostic Shift and other Temporal Changes
- 14 Future Directions in Sudden Unexpected Death in Infancy Research
- 15 Observational Investigations from England: The CESDI and SWISS Studies
- 16 An Australian Perspective
- 17 A South African Perspective
- 18 A United Kingdom Perspective
- 19 A United States Perspective
- 20 A Scandinavian Perspective
- 21 Neonatal Monitoring: Prediction of Autonomic Regulation at 1 Month from Newborn Assessments
- 22 Autonomic Cardiorespiratory Physiology and Arousal of the Fetus and Infant
- 23 The Role of the Upper Airway in SIDS and Sudden Unexpected Infant Deaths and the Importance of External Airway-Protective Behaviors
- 24 The Autopsy and Pathology of Sudden Infant Death Syndrome
- 25 Natural Diseases Causing Sudden Death in Infancy and Early Childhood
- 26 Brainstem Neuropathology in Sudden Infant Death Syndrome
- 27 Sudden Infant Death Syndrome, Sleep, and the Physiology and Pathophysiology of the Respiratory Network
- 28 Neuropathology of Sudden Infant Death Syndrome: Hypothalamus
- 29 Abnormalities of the Hippocampus in Sudden and Unexpected Death in Early Life
- 30 Cytokines, Infection, and Immunity
- 31 The Genetics of Sudden Infant Death Syndrome
- 32 Biomarkers of Sudden Infant Death Syndrome (SIDS) Risk and SIDS Death
- 33 Animal Models: Illuminating the Pathogenesis of Sudden Infant Death Syndrome
Summary
Introduction
Despite intensive research over the past decades, the mechanisms which lead to sudden infant death syndrome (SIDS) still remain elusive. SIDS is presumed to occur in an apparently healthy infant during a period of sleep (1). A failure of cardiorespiratory control mechanisms, together with an impaired arousal from sleep response, are believed to play an important role in the final event of SIDS. Sleep has a marked influence on respiratory and cardiovascular control in both adults and infants, although sleep states, sleep architecture, and arousal from sleep processes in infants are very different from those of adults and undergo significant maturation during the first year of life, particularly in the first six months when SIDS risk is greatest (2).
Arousal from sleep involves both physiological and behavioral responses and has long been considered a vital survival response for restoring homeostasis in reaction to various life-threatening situations, such as prolonged hypoxia or hypotension (3). There are two distinct arousal types defined in infants, subcortical activation and full cortical arousal, which reflect the hierarchical activation from the brainstem (including heart rate, blood pressure, and ventilation changes) to the cortex (4). Any impairment of these protective responses may render an infant vulnerable to the respiratory and cardiovascular instabilities that are common during infancy and that have been postulated to occur in SIDS. In support of this possibility, extensive physiological and neuropathological studies have provided compelling evidence that impaired cardiovascular control, with a concomitant failure to arouse from sleep, are involved in the final events leading to SIDS. The first six months of life are a critical period of development when rapid maturation of the brain, cardiorespiratory system, and sleep state organization are all taking place (2, 5). Thus, the investigation of sleep physiology in healthy infants during this high-risk period provides important insights into the likely mechanisms involved in the pathogenesis of SIDS.
Development of Sleep
The maturation of sleep is one of the most important physiological processes occurring during the first year of life and is particularly rapid during the first six months after birth (5). Behavioral states in infants are defined by physiological and behavioral variables that are stable over time and occur repeatedly in an individual infant and also across infants (6). The emergence of sleep states is dependent on the central nervous system and is a good and reliable indicator of normal and abnormal development (7).
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- SIDS Sudden Infant and Early Childhood DeathThe past, the present and the future, pp. 449 - 490Publisher: The University of Adelaide PressPrint publication year: 2018