Hypoxic and hypercapnic events in young infants during bed-sharing.
OBJECTIVE
To identify desaturation events (arterial oxygen saturation [Sao(2)] <90%) and rebreathing events (inspired carbon dioxide (CO(2)) >3%), in bed-sharing (BS) versus cot-sleeping (CS) infants.


METHODS
Forty healthy, term infants, aged 0 to 6 months who regularly bed-shared with at least 1 parent >5 hours per night and 40 age-matched CS infants were recruited. Overnight parent and infant behavior (via infrared video), Sao(2), inspired CO(2) around the infant's face, and body temperature were recorded during sleep at home.


RESULTS
Desaturation events were more common in BS infants (risk ratio = 2.17 [95% confidence interval: 1.75 to 2.69]), associated partly with the warmer microenvironment during BS. More than 70% of desaturations in both groups were preceded by central apnea of 5 to 10 seconds with no accompanying bradycardia, usually in active sleep. Apnea >15 seconds was rare (BS infants: 3 events; CS infants: 6 events), as was desaturation <80% (BS infants: 3 events; CS infants: 4 events). Eighty episodes of rebreathing were identified from 22 BS infants and 1 CS infant, almost all preceded by head covering. During rebreathing, Sao(2) was maintained at the baseline of 97.6%.


CONCLUSIONS
BS infants experienced more oxygen desaturations preceded by central apnea, partly related to the warmer microenvironment. Rebreathing occurred mainly during bed-sharing. Infants were at low risk of sudden infant death syndrome and maintained normal oxygenation. The effect of repeated exposure to oxygen desaturation in vulnerable infants is unknown as is the ability of vulnerable infants to respond effectively to rebreathing caused by head covering.
Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand.sally.baddock@op.ac.nz
Sally A
SA
Baddock
Barbara C
BC
Galland
David P G
DP
Bolton
Sheila M
SM
Williams
Barry J
BJ
Taylor
D001513:Beds; D002245:Carbon Dioxide / Q000097:blood*; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology*; D000860:Hypoxia / Q000503:physiopathology*; D007223:Infant; D015370:Infant Equipment; D007231:Infant, Newborn; D008297:Male; D008425:Maternal Behavior; D009769:Object Attachment; D016017:Odds Ratio; D010100:Oxygen / Q000097:blood*; D020182:Sleep Apnea, Central / Q000503:physiopathology; D012894:Sleep Stages / Q000502:physiology; D012931:Social Environment; D013398:Sudden Infant Death / Q000209:etiology / Q000517:prevention & control
D002245:Carbon Dioxide; D010100:Oxygen