To the Editor.
—Extensive data were gathered for the four articles1-4 on sudden infant death syndrome (SIDS), but no analysis of the time of death of these infants or the possible role of circadian rhythm was presented. Our own analysis of 2351 such deaths with autopsy verification demonstrated a definite circadian rhythm.5 In the SIDS registry for 1976 through 1985 from Cook County Illinois, the times of death, determined by case analysis and pathologic study, tended to increase between 8 AM and noon and peaked between noon and 1 PM, a remarkable correspondence with the timing of nontraumatic sudden deaths that occurred during adult life, particularly as observed among those succumbing to cardiovascular and cerebrovascular disease.Although our data fail to demonstrate the reason for this circadian rhythm, the tendency could be attributed to surges in catecholamines, cortisol, and platelet aggregability, and also to decreases in fibrinolytic activity
Wehrmacher WH. Sudden Infant Death Syndrome and Circadian Rhythm. JAMA. 1995;274(12):944. doi:10.1001/jama.1995.03530120036035