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Effect of Sleep Position on Apnea and Bradycardia in High-Risk Infants

Journal of Perinatology volume 21, pages 85–89 (2001)Cite this article

Abstract

OBJECTIVE:The purpose of this investigation was to investigate, in high-risk infants, the occurrence of abnormalities in documented monitor downloads during the side versus prone position.

STUDY DESIGN:Forty infants admitted to the A. I. duPont Hospital for Children with diagnoses associated with sudden infant death syndrome were included in this investigation. During an overnight hospitalization, infants were placed on home apnea monitors, with computer memory to capture alarms for apnea >20 seconds, age-defined bradycardia, and tachycardia. Infants were studied for 12 hours. Each infant was assigned to 6 hours of prone and side during the 12-hour period, with order of position randomly assigned by random number generation. Differences between the two positions in alarm frequency and significant events, as determined by a blinded interpreting physician were analyzed by Fisher exact test, with p<0.05. Power analysis necessitated 20 patients in each group, with beta error of 0.2.

RESULTS:Eleven episodes of apnea occurred in the prone position, and 16 in the side position (p=NS). The mean numbers of apnea events per tracing in the prone position was 0.27±0.84 and 0.39±1.1 in the side position (p=0.58). The mean number of bradycardia events per tracing in the prone position was 0.44±1.45 and 0.49±1.94 in the side position(p=0.9).

CONCLUSION:Clinicians need to be cautious when recommending the side or prone position in this group of high-risk infants. The results in this investigation provide support for the Back to Sleep Campaign recommendations to be applied, not only to healthy term infants, but higher risk infants as well. Studies of the high-risk infant in the supine position are warranted.

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Authors and Affiliations

  1. Division of Nursing (M.L.H., K.L.P.), Alfred I. DuPont Hospital for Children, Wilmington, DE, USA

    Marjorie L Hershberger MS, RN C, CPNP & Kathleen L Peeke MS, RN C

  2. Thomas Jefferson Medical College (J.L., M.L.S.), Philadelphia, PA, USA

    Jacqueline Levett MSN, RN

  3. Division of Neonatology (J.L., Department of Pediatrics, M.L.S.), Christiana Care Health Services, Newark, DE, USA

    Michael L Spear MD

Authors
  1. Marjorie L Hershberger MS, RN C, CPNP
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  2. Kathleen L Peeke MS, RN C
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  3. Jacqueline Levett MSN, RN
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  4. Michael L Spear MD
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Presented in part at the Fourteenth Conference on Apnea of Infancy in Rancho Mirage, California, January 1996.

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Hershberger, M., Peeke, K., Levett, J. et al. Effect of Sleep Position on Apnea and Bradycardia in High-Risk Infants. J Perinatol 21, 85–89 (2001). https://doi.org/10.1038/sj.jp.7200479

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