One of the latest and most buzzed about items for infants are vital sign monitors like the Owlet or Snuza. These new devices are being marketed as a way to alert parents when babies stop breathing, stopping just short of claiming to prevent SIDS. Some parents praise these monitors, while others lose sleep at night because of false alarms. So what level, if any, should we rely on them? It’s my opinion, backed by research, that parents should not invest in or use these monitors for their infants.
As a pediatrician, I always discuss the importance of safe sleeping practices for infants, but I am also learning to discuss parental reliance on vital sign sleep monitors. My concern is that these monitors may give parents a false sense of security and contribute to laxity when it comes to following the AAP safe sleep recommendations (which you can review in our SIDS blog post).
The newest monitors on the market trigger an alarm if a baby's breathing stops briefly (apnea), if the heart rate is unusually slow (bradycardia) or if the oxygen level is low (hypoxia). Given everything we know about SIDS, monitors sound like a foolproof way to prevent it, right? Not exactly. According to research, most children DO NOT need a monitor. The American Academy of Pediatrics found that:
1. Apnea monitors give little or no protection from SIDS.
Even full-term newborns in the first few weeks of life may have brief periods of apnea, but research has not shown a clear link between this and SIDS.
2. Monitors cause unnecessary worry.
Home apnea monitors cause many false alarms which can make parents worry and actually lose more sleep.
One study found that parents of monitored infants said they felt more depressed, compared to parents of infants that weren't monitored.
Further, the result from these monitors can often be an overdiagnosis. According to another recent study, “Even if one could assume that consumer monitors are highly accurate, the clinical appropriateness of monitoring healthy infants would remain in question. By continuously monitoring healthy infants, parents will inevitably experience some alarms for conditions that are not life-threatening, including false positive alarms due to motion artifact or other causes, and true positive alarms for events that are not clinically important. It is well-established that healthy infants have occasional oxygen desaturations to below 80% without consequence, placing them at risk of overdiagnosis and harm if these innocuous events generate alarms.”
In plain speak, if parents bring their children to the hospital because of these alarms, babies may undergo unnecessary tests, X-rays and other procedures that are expensive and even potentially harmful. Parents need to understand that fluctuations are common and do not mean that a baby needs immediate emergency care.
So far, these monitors only alert parents to potential health threats, they DO NOT prevent SIDS. And since these monitors do not claim to prevent SIDS, they are not regulated by the FDA. They are not and should not be used as a medical device. That said, I understand why parents would want to use these devices. The newborn and infant months are fraught with worry and parents are just trying to do what they think is best and safest for their child. I would rather parents’ effort and money go into ensuring safe sleep practices rather than toward a vital sign monitor.
All this said, I want to applaud these companies for conducting research to determine the application of these monitors for SIDS prevention. A study funded by Owlet manufacturers that was published in December 2017 even reports the company “collaborates with established investigators in prospective studies with FDA-approved pulse oximetry devices.” So stay tuned… this could be really cool!
For now, my hope is to educate parents on both topics. I also believe that parents know their children, so if you do think your child has shown signs of sleep apnea, you should immediately discuss with your pediatrician. You know your child’s rhythms better than anyone, so trust your gut. I’m always open to speaking with parents more in depth about sleep apnea, SIDS and vital sign monitors. Simply email firstname.lastname@example.org.