Safe to Sleep

Project Status: In Sustainment

Gutman CE, Scott PA, Morad A, Barker B, Scott TA. Safe to Sleep in Tennessee: A Statewide Quality Improvement Initiative. Am J Perinatol. 2023 May 11. doi: 10.1055/s-0043-1768705. Epub ahead of print. PMID: 37168012.

Project AIM

The Safe Sleep project was selected by stakeholders at the 2019 TIPQC Annual Meeting. This decision was supported by recent increase in sleep related deaths in Tennessee. Participating institutions will agree to
the following:

Implement the project as designed
Collecting and submit the monthly data in a timely manner
Participate in monthly webinars and statewide meetings

Project Narrative

Sleep related infant deaths are identified when a baby is found deceased in a sleeping environment and is found with his or her head pressed into the mattress or pillow, in the presence of a co-sleeper, found wedged against an object, or when an infant is found in other circumstances that may have contributed to the infant’s suffocation or strangulation. Sleep related infant deaths may also be classified as Sudden Infant Death Syndrome (SIDS). SIDS is considered an exclusionary cause of death for children under one year of age. A diagnosis of SIDS indicates that all evidence (including an autopsy, death scene investigation, and review of the medical record) has failed to yield the specific cause of death. SIDS deaths are classified under sleep related infant deaths. The cause and manner of death in these cases are determined from the information obtained from the death scene investigation and after a medical examiner’s autopsy. When seemingly healthy infants fail to awaken from sleep, their deaths may be considered to be due to SIDS, the result of suffocation related to the sleep environment, or the sign of an undiagnosed childhood malady. The exact cause of death may be difficult, if not impossible, to determine (SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, Task Force on Sudden Infant Death Syndrome, 2016).

It is estimated that approximately 3500 infants die annually in the United States from sleep related infant deaths. This includes sudden infant death syndrome, ill-defined deaths, and accidental suffocation and strangulation. After an initial decrease in the 1990s, the overall death rate attributable to sleep-related infant deaths has not declined in more recent years (SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, Task Force on Sudden Infant Death Syndrome, 2016).

In Tennessee for the years 2014-2018, Sudden Infant Death Syndrome was the 4th leading cause of infant death. The chart below shows the number of sleep-related deaths for the past five years.