Gastro-oesophageal reflux, sleep pattern, apparent life threatening event and sudden infant death. The point of view of a gastro-enterologist

Abstract

Sudden infant death, apparent life threatening events and regurgitation occur mostly during the first 6 months of life, making it very tempting to suspect a relation between these phenomena. According to epidemiological data, the role of gastro-oesophageal reflux in the aetiology of apparent life threatening events is unclear. It has been demonstrated that sudden infant death is decreased in the supine versus the prone sleeping position. On the contrary, gastro-oesophageal reflux is more pronounced in the supine than in the prone position, both in infants and in older children, both in infants with physiological and with pathological reflux. In the supine position, infants do sleep shorter, have more rapid-eye-movement sleep and have more arousals than in the prone position.

Conclusion It is thought that in the majority of infants, gastro-oesophageal reflux stimulates arousals and thus may well be considered as “protective” for rather than “provoking” sudden infant death. However, this hypothesis needs to be validated.