The influence of a pacifier on infants' arousals from sleep

Objective: The risk of sudden infant death during sleep was postulated to d ecrease with the use of a pacifier and ny conditions facilitating arousals from sleep. We evaluated the influence of a pacifier on arousal from sleep in healthy infants. Study design: Fifty-six healthy infants were studied with polygraphy during 1 night; 36 infants used a pacifier regularly during sleep, and 20 never u sed a pacifier. Thumb users or occasional pacifier users were not included in the study. The infants were recorded at a median age of 10 weeks (range 6 to 19 weeks). To evaluate auditory arousal thresholds, the infants were e xposed to white noise of increasing intensity during rapid Eye movement sle ep. Results: Polygraphic arousals occurred at significantly lower auditory stim uli in pacifier users than in nonusers (P = .010), Compared with nonusers, pacifier users were more frequently bottle-feel than breast-fed (P = .036). Among infants sleeping without a pacifier, breast-fed infants had lower au ditory thresholds than bottle-fed infants (P = .049). Conclusions: Infants using pacifiers during sleep had lower auditory arousa l thresholds than those who did not use a pacifier during sleep. Breast-fee ding could be a further factor contributing to lower arousal thresholds. Th ese findings could be relevant to the occurrence of sudden infant deaths du ring sleep.