The promotion of supine sleeping position in young infants has resulted in
significant declines in the incidence of Sudden Infant Death Syndrome altho
ugh little is understood in terms of mechanisms. We hypothesize that supine
sleeping position promotes appropriate thermal regulation via the face and
head which is the major source of infant heat loss. By facilitating temper
ature regulation, the supine position ensures that the centre for thermoreg
ulation in the hypothalamus does not become dysfunctional due to local temp
erature fluctuations. Because these hypothalamic, thermoregulatory neurones
are synaptically linked to those regulating respiration in the medulla, ad
equate temperature control by the infant maintains normal respiration. In c
ontrast, an increase in face and head temperature over and above core tempe
rature would suggest thermoregulatory stress and an increased likelihood of
respiratory apnoea. (C) 2001 Harcourt Publishers Ltd.