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The Back to Sleep campaign has led to a dramatic decline in the incidence of sudden infant death syndrome (SIDS). However, SIDS remains the leading cause of postneonatal death in the U.S. Investigators in California examined the effect of environmental factors, including room ventilation, in a population-based case-control study of 185 infants who died of SIDS and 312 randomly selected matched infants (controls).
Cases and controls differed significantly in several factors related to SIDS, including last sleep position (stomach or side in 69% vs. 44%, respectively), bed-sharing with a nonparent (14% vs. 5%), and presence of regular smokers in the home (11% vs. 6%). In analyses that controlled for SIDS-related variables, fan use in the room during the last sleep was associated with significantly reduced risk for SIDS (odds ratio, 0.28). The effect of fan use was especially pronounced in adverse sleep environments (e.g., room temperatures above 21°C and rooms with closed windows) and in infants who did not use pacifiers.
Coleman-Phox K et al. Use of a fan during sleep and the risk of sudden infant death syndrome. Arch Pediatr Adolesc Med 2008 Oct; 162:963.
Comment
The authors suggest that fan use might reduce the risk for SIDS by decreasing rebreathing and increasing dispersion of carbon dioxide in the infant’s airway; however, case-control studies do not prove causality. Other possible explanations include recall bias and unmeasured characteristics associated with SIDS among families (and infants) that use fans.