[SIDS and polygraphy]

Abstract

The description of an association between central apneas and the sudden infant death syndrome (SIDS) by Steinschneider et al. in 1972 was followed by a sharp rise of polygraphic studies. The hope to use these as a screening method for an increased risk of SIDS could subsequently not be confirmed by prospective studies. Pathological alterations, such as obstructive apneas and hypoxemias, however, seem to have prognostical relevance. They thus represent a focus of current research even though being unable as well to reliably predict a predisposition to SIDS for an individual subject. Instead of being used as a diagnostic tool for SIDS, polygraphic studies have nowadays acquired an accepted role in the investigation of certain physical symptoms and signs such as unexplained 'apparent life threatening events' (ALTE) or cyanotic attacks. Basic technical requirements for a polygraphic laboratory include facilities to record thoracic/abdominal respiration, nasal air flow, ECG/heart rate, oxygen saturation, and to classify different stages of sleep. Registration of additional parameters (EEG, breath sounds, video etc.) is optional, but may prove helpful to arrive at an appropriate diagnosis. Recently, Austrian and German centres have been trying in cooperation to standardize performance conditions and evaluation criteria for polygraphic measurements in pediatric patients under the guidance of the German Association for Sleep Medicine, Pediatric Workgroup. Their aim is to establish common guidelines for the diagnosis and treatment of sleep and arousal disorders in infancy and childhood.