Rebreathing of exhaled gases: Importance as a mechanism for the causal association between prone sleep and sudden infant death syndrome

Twenty to 52% of sudden infant death syndrome (SIDS) victims are found dead with their noses and mouths turned into underlying bedding. Several items of bedding have been shown to increase the risk for SIDS in case- control studies or to be associated with many SIDS deaths in case series. These items of bedding are softer, limit CO₂ dispersal more, and cause more rebreathing of exhaled gases than bedding infrequently associated with SIDS. Rebreathing of exhaled gases may explain some prone deaths, and avoiding rebreathing of these gases is one possible mechanism for the reduction in SIDS when infants avoid prone sleep. Results supporting these statements are reviewed and discussed.