Multiple Unsafe Sleep Factors Characterize SIDS Incidences

On Tuesday, February 20, 2024, the American Academy of Pediatrics (AAP) journal, Pediatrics, published a study characterizing factors in sudden unexpected infant deaths (SUID), which is sometimes called sudden infant death syndrome (SIDS). Although the study hoped to compare characteristics between infants who shared sleep surfaces and those who didn’t, the researchers concluded that SUID cases had multiple unsafe sleep factors regardless of shared sleep surface status.

The study analyzed SUID cases between 2011 and 2020, collecting data from the CDC’s SUID Case Registry. Focusing on 23 jurisdictions in the United States, the publication included data from 7,595 SUID cases, noting that 59.5% of the incidences were sleep surface sharing.

According to the publication, sleep surface sharing was more common in younger infants (0–3 months) and non-Hispanic Black individuals. Additionally, the following factors were associated with a higher probability of sleep-sharing:

• Being publicly insured
• Being found in a supine position
• Sleeping in an adult bed, a chair, or on a couch
• Having more unsafe sleep factors present
• Prenatal maternal cigarette smoke exposure
• Parent supervision at the time of death
• Supervision by a substance-impaired individual at the time of death

While cases with a higher number of unsafe sleep factors were more likely to be surface sharing, the publication notes that 76% of all SUID cases — regardless of surface sharing — were linked to multiple unsafe sleep factors.

“Characteristics of surface sharing and nonsharing infants among SUID varied by age at death, race and ethnicity, infant insurance type, and presence of unsafe sleep factors. However, most SUID had multiple unsafe sleep factors present regardless of sharing status,” concluded researchers in the publication.

The investigators note that this data can facilitate discussions about safe sleep habits with parents, emphasizing that infants should sleep in a supine position, on a nonshared sleep surface, in a crib or bassinet, without soft bedding. The AAP also provides additional guidelines for safe sleep.

While researchers continue to research and hypothesize the cause of SUID or SIDS, parents must follow safe sleep guidelines to minimize their child’s risk.