Why Mainstream SIDS Research Is Not Achieving Its Goal

Abstract

The cardiorespiratory paradigm is used to explain the aetiology of SIDS and has been the focus of intense research for many decades without providing consistent and meaningful data to support such an hypothesis. Despite this, papers citing central nervous system, cardiac and sleep arousal findings continue to be unremittingly published but without addressing SIDS risk and other factors. This paper is a succinct analysis of current cardiorespiratory SIDS research and its relationship (or not) to the established clinicopathological data and epidemiological risk factors. Epidemiological research into the aetiology of SIDS produced a milestone with the discovery of the prone sleep position risk factor which provided support for the cardiorespiratory control hypothesis which in itself defines the approach used by mainstream researchers. Since then mainstream research has stalled. The question is why? This analysis shows that there is very poor correlation between brainstem and other central nervous system pathological findings and other clinicopathological data and SIDS risk factors. A few studies show a link to a small number of risk factors, however, for the majority of papers there remains a glaring absence of data to link central nervous system pathology findings with the key risk factor of prone sleep position which is the central column upon which the cardiorespiratory paradigm stands. Nor do the studies correlate central nervous system findings with recent infection, contaminated sleeping surfaces, maternal/obstetric/higher birth, ethnicity, non-breast-feeding, etc. or with the usual gross pathological findings of SIDS (intrathoracic petechiae, liquid blood, congested fluid-laden lungs). Because of these shortcomings, this paper should provoke questions over current research directions and invites research into other more plausible hypotheses, such as the infection paradigm.