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Apnea as a causative factor of SIDS was first proposed in 1972. This led to a great number of home apnea monitors being used on babies in an attempt to detect apnea and prevent SIDS. However, the original research evidence was later shown to be invalid. The apnea theory of SIDS has since been discredited and abandoned. The AAP strongly discourages the use of home apnea monitors to prevent SIDS. Research in the past decade has focused on serotonin receptor abnormalities in SIDS victims. These receptors, found in the brain stem, are involved in medullary arousal responses. Ultrastructural, as well as genetic, differences have been identified between SIDS victims and control babies who died for other reasons. The current working hypothesis of SIDS is not that a previously healthy baby suddenly stops breathing (apnea) and dies. Rather, it is that a genetically predisposed infant fails to respond (arousal) normally to the hypoxia and hypercarbia caused by certain stresses in the sleep environment. The best known of these is the prone sleeping position. Prone sleeping may lead to hypoxia and hypercarbia in several ways - overheating, airway obstruction or rebreathing of exhaled carbon dioxide. |