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Use of Fan During Sleep and the Risk of Sudden Infant Death Syndrome

Use of Fan During Sleep and the Risk of Sudden Infant Death Syndrome. De-Kun Li, MD, PhD Division of Research Kaiser Permanente Oakland, California March 24, 2009. Background. What do we know about SIDS etiology? Heterogeneity in etiology – diagnosis by exclusion. Brain Stem.

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Use of Fan During Sleep and the Risk of Sudden Infant Death Syndrome

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  1. Use of Fan During Sleep and the Risk of Sudden Infant Death Syndrome De-Kun Li, MD, PhD Division of Research Kaiser Permanente Oakland, California March 24, 2009

  2. Background • What do we know about SIDS etiology? • Heterogeneity in etiology – diagnosis by • exclusion

  3. Brain Stem Heart Problem Underlying Biological Susceptibility SIDS RISK WITH AGE SIDS RISK Environmental Triggers First 9 months Sleep Environment Infections Air Pollution

  4. Maternal smoking Resuscitation Capability Infection Brain Stem Deficiency Prenatal Exposure Preeclampsia Gestational Diabetes Thermoregulation Genetic Factors?

  5. Sleep Position Sleep Environment Pacifier Use Soft Bedding Fan Use Bed Sharing

  6. Background • Sleep environment matters • Oxygen deprivation • CO2re-breathing? • Thermal factor? • Other factors?

  7. Objectives • To examine whether use of a fan in the room impacts the risk of SIDS • To examine whether any other factors influence the relationship between use of a fan and the risk of SIDS • To examine whether opening of a window also has a similar effect on the risk of SIDS as use of a fan

  8. Study Design • Population-based case-control study • Study population All confirmed SIDS cases in 11 counties in California  Infant age-, ethnicity-matched controls in the same county  English or Spanish speaking Participation rate: 50% in cases and 41% in controls

  9. Study Design • In-person interview • Use of a fan during the last sleep • Sleep positions • Sleep environment (co-sleep, pacifier, etc) • Other risk factors for SIDS

  10. Statistical analysis • Logistic regression to adjust for confounders • Stratification for evaluating interaction • Comparison with birth certificate data to assess participation bias

  11. Limitations • Low participation rate • Adjustment for socio-demographic factors • Strong protective effect ---- strong participation bias • Compare to birth certificate data • Recall bias? Adjusting for recall interval

  12. Comparison between Participants and Source Population

  13. Limitations • Limited information related to fan use • Duration • Location • Type of fan used (ceiling, floor, etc) • Orientation of the fan (facing or away)

  14. Conclusions • Use of fan in the sleeping room may reduce the risk of SIDS • The finding is consistent with other known factors in the sleep environment that influence the SIDS risk • Use of a fan could be another simple and effective way to further reduce SIDS

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