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September 27, 1995

Sudden Infant Death Syndrome and Circadian Rhythm-Reply

Author Affiliations

National Institutes of Health Bethesda, Md

JAMA. 1995;274(12):944. doi:10.1001/jama.1995.03530120036036

In Reply.  —There are many observations to be considered in developing testable hypotheses regarding the pathogenesis of SIDS and in developing effective interventions. As far as circadian rhythmicity is concerned, SIDS infants have been shown to have decreased melatonin in body fluids compared with control infants.1 Patterns of sleep states and wakefulness across the night are also different for SIDS infants compared with control infants.1 The SIDS infants have more periods of wakefulness in the hours between 7 and 11 PM and less periods of wakefulness between 3 and 7 AM. More rapid eye movement sleep and quiet sleep have also been observed in SIDS infants between 3 and 7 AM compared with controls.In addition to the surges of hormonal and immune factors listed by Dr Wehrmacher, arousal, sleep state, and thermoregulation of the infant are under circadian control. It remains to be determined how all these factors

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