Abstract
Sudden infant death syndrome (SIDS) is the leading cause of death in infants between the ages of 1 and 12 months in developed countries. SIDS is by definition a diagnosis of exclusion, and its mechanism of action is unknown. The SIDS–Critical Diaphragm Failure (CDF) hypothesis postulates that the cause of death in SIDS is respiratory failure caused by CDF. Four principal risk factors contribute to CDF in young infants: undeveloped respiratory muscles, non-lethal infections, prone resting position, and REM sleep. Even relatively minor infections can cause an acute and significant reduction in diaphragm force generation capacity that in conjunction with other risk factors can precipitate CDF. CDF-induced acute muscle weakness leaves few, if any pathological marks on the affected tissue.Understanding the underlying mechanism of SIDS may help in formulating new approaches to child care that can help to further reduce the incidence of SIDS.
Highlights
It has been recognized since antiquity that seemingly healthy infants can die suddenly and for no obvious reason during their sleep
It is perhaps surprising that research areas unrelated to sudden infant death syndrome (SIDS) could contribute meaningfully to the understanding of this complex syndrome, and yet there is a large body of experimental and clinical evidence that suggests that the cause of death in SIDS is respiratory failure caused by Critical Diaphragm Failure (CDF)
We argue that four factors contribute to CDF in SIDS: undeveloped respiratory muscles, non-lethal infections, prone resting position, and REM sleep
Summary
It has been recognized since antiquity that seemingly healthy infants can die suddenly and for no obvious reason during their sleep. We argue that four factors contribute to CDF in SIDS: undeveloped respiratory muscles, non-lethal infections, prone resting position, and REM sleep. Infants younger than 6 months have undeveloped respiratory muscles that are susceptible to CDF, because even minor infections can precipitate a significant reduction in the diaphragm force generation capacity.
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