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American Academy of Pediatrics
Article

Hypoxic and Hypercapnic Events in Young Infants During Bed-sharing

Sally A. Baddock, Barbara C. Galland, David P.G. Bolton, Sheila M. Williams and Barry J. Taylor
Pediatrics August 2012, 130 (2) 237-244; DOI: https://doi.org/10.1542/peds.2011-3390
Sally A. Baddock
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Barbara C. Galland
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David P.G. Bolton
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Sheila M. Williams
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Barry J. Taylor
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Abstract

OBJECTIVES: To identify desaturation events (arterial oxygen saturation [Sao2] <90%) and rebreathing events (inspired carbon dioxide (CO2) >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), Sao2, inspired CO2 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, Sao2 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.

KEY WORDS
  • co-sleeping
  • infant
  • oxygen desaturation
  • rebreathing
  • thermoregulation
  • sudden infant death syndrome
  • sleep
  • Abbreviations:
    AS —
    active sleep
    BS —
    bed-sharing
    CI —
    confidence interval
    CO2 —
    carbon dioxide
    CS —
    cot-sleeping
    HR —
    heart rate
    QS —
    quiet sleep
    Sao2 —
    arterial oxygen saturation
    SIDS —
    sudden infant death syndrome
    • Accepted April 20, 2012.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 130, Issue 2
    1 Aug 2012
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    Hypoxic and Hypercapnic Events in Young Infants During Bed-sharing
    Sally A. Baddock, Barbara C. Galland, David P.G. Bolton, Sheila M. Williams, Barry J. Taylor
    Pediatrics Aug 2012, 130 (2) 237-244; DOI: 10.1542/peds.2011-3390

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    Hypoxic and Hypercapnic Events in Young Infants During Bed-sharing
    Sally A. Baddock, Barbara C. Galland, David P.G. Bolton, Sheila M. Williams, Barry J. Taylor
    Pediatrics Aug 2012, 130 (2) 237-244; DOI: 10.1542/peds.2011-3390
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