Abstract
Aim: To determine instantaneous cardiac variability responses to increased carbon dioxide (CO2) during quiet sleep in infants who may be at risk for the Sudden Infant Death syndrome (SIDS). Methods: The cardiac rate variability before, during and after a CO2 challenge was examined in 41 infants who had experienced an apparent life‐threatening event (ALTE) and 41 gender‐ and age‐matched control infants. Results: The ALTE infants responded to CO2 breathing with a significant increase in R‐R intervals, i.e. decreases in heart rate, compared to the controls (45.1% increase in R‐R intervals vs. 41.4%; p= 0.005). The differences between ALTE infants and controls depended primarily on the boys' responses. Conclusion: ALTE infants, particularly ALTE boys, have an autonomic dysfunction—lower sympathetic stimulation and/or inhibited vagal withdrawal when stressed with CO2. The outcome might provide clues to the mechanisms underlying the cardiovascular processes contributing to the terminal event in SIDS.
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