Estimated Prevalence of Obstructive Sleep Apnea–Hypopnea Syndrome After Cervical Cord Injury
Presented in part to the Canadian Association of Physical Medicine and Rehabilitation, June 16−19, 2005, Ottawa, ON, Canada.
Abstract
Leduc BE, Dagher JH, Mayer P, Bellemare F, Lepage Y. Estimated prevalence of obstructive sleep apnea–hypopnea syndrome after cervical cord injury.
Objectives
To estimate the prevalence of obstructive sleep apnea–hypopnea syndrome (OSAHS) in patients with cervical cord injury and to identify predictive factors.
Design
Cross-sectional study.
Setting
Rehabilitation center.
Participants
Forty-one adults with cervical cord injury of more than 6 months in duration.
Interventions
Medical history, physical exam, and full in home overnight polysomnography were undertaken. Data were collected on characteristics of spinal cord injury, current medication, sleeping habits, daytime sleepiness, body mass index (BMI), and neck circumference.
Main Outcome Measure
Presence or absence of OSAHS as defined by the American Academy of Sleep Medicine criteria (1999).
Results
Twenty-two (53%) patients (95% confidence interval [CI], 38.4%–68.9%) had OSAHS. Daytime sleepiness (odds ratio [OR], 41.1; 95% CI, 2.3–739.7; P=.02), BMI of 30kg/m2 or higher (OR=17.2; 95% CI, 1.4–206.4; P=.03), and 3 or more awakenings during sleep (OR=34; 95% CI, 1.6–744.8; P=.03) were the best predictive factors of OSAHS obtained by a forward stepwise multiple logistic regression.
Conclusions
The estimated prevalence of OSAHS is high after cervical cord injury. OSAHS should be suspected, especially in patients with daytime sleepiness, obesity, and frequent awakenings during sleep.
aDepartment of Physical Medicine and Rehabilitation, Institut de Réadaptation de Montréal, Montreal, QC, Canada
bRespiratory Division and Sleep Laboratory, Centre Hospitalier de l’Université de Montréal-Hôpital Hôtel-Dieu, Montreal, QC, Canada
cDepartment of Mathematics and Statistics, Université de Montréal, Montreal, QC, Canada.
Correspondence to Bernard E. Leduc, MD, FRCPC, Institut de Réadaptation de Montréal, 6300 Darlington St, Montreal, QC H3S 2J4, Canada
Supported by the Fondation pour la Recherche sur la Moelle Épinière.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT