CONSEQUENCES OF GETTING THE HEAD COVERED DURING SLEEP IN INFANCY

Objective. To study the consequences of getting the head covered by be dding (fiber quilt) on carbon dioxide (CO2) accumulation around the fa ce, behavior, and physiologic responses during prone and supine sleep in infants to add understanding to why victims of sudden infant death syndrome are often found under the bedding. Methodology. Of 33 healthy term, usually nonprone sleeping infants, behavior and computerized po lysomnography were successfully recorded for 30 during prone and supin e sleep at 2 1/2 months and for 23 prone and 25 supine at 5 months. Re sults. For both ages and body positions, covering the head resulted in significant CO2 accumulation around the face, fewer apneas (3 to 10 s econds), shorter duration of apneas after sighs, higher heart and resp iratory rates, and peripheral skin temperature. Differences were gener ally greater at 2 1/2 than at 5 months. While covered, the prone posit ion was associated with higher CO2 levels close to the face, slightly higher transcutaneous PCO2, and higher heart rates and peripheral skin temperatures than the supine position. In the supine position 23% wer e able to remove the cover from the head at 2 1/2 and 60% at 5 months, whereas only 1 infant of 5 months managed to remove the cover when pr one. Conclusions. The observed responses are consistent with a potenti al for distress when the head is covered, particularly when placed pro ne. Probably most important with respect to sudden infant death syndro me is the infants' inability to remove the bedding from the head upon awakening from prone sleep.