Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 3 , Pages 333-337, March 2007

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.

  • Bernard E. Leduc, MD, FRCPC

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Institut de Réadaptation de Montréal, Montreal, QC, Canada
    • Corresponding Author InformationCorrespondence to Bernard E. Leduc, MD, FRCPC, Institut de Réadaptation de Montréal, 6300 Darlington St, Montreal, QC H3S 2J4, Canada
    • ,
  • Jehan H. Dagher, MD, FRCPC

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Institut de Réadaptation de Montréal, Montreal, QC, Canada
    • ,
  • Pierre Mayer, MD, FRCPC

      Affiliations

    • Respiratory Division and Sleep Laboratory, Centre Hospitalier de l’Université de Montréal-Hôpital Hôtel-Dieu, Montreal, QC, Canada
    • ,
  • François Bellemare, PhD

      Affiliations

    • Respiratory Division and Sleep Laboratory, Centre Hospitalier de l’Université de Montréal-Hôpital Hôtel-Dieu, Montreal, QC, Canada
    • ,
  • Yves Lepage, PhD

      Affiliations

    • Department of Mathematics and Statistics, Université de Montréal, Montreal, QC, 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.

Key Words: Rehabilitation, Sleep apnea syndromes, Spinal cord injuries, Tetraplegia

 

 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.

 Reprints are not available from the author.

PII: S0003-9993(06)01582-6

doi:10.1016/j.apmr.2006.12.025

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 3 , Pages 333-337, March 2007

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