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.

References 

  1. Biering-Sorensen F, Biering-Sorensen M. Sleep disturbances in the spinal cord injured: an epidemiological questionnaire investigation, including a normal population. Spinal Cord. 2001;39:505–513
  2. Epstein LJ, Brown R. Sleep disorders in spinal cord injury. In:  Lin VW editors. Spinal cord medicine: principles and practice. New York: Demos; 2002;p. 169–177
  3. Frisbie JH, Brown R. Waist and neck enlargement after quadriplegia. J Am Paraplegia Soc. 1994;17:177–178
  4. Berlowitz DJ, Brown DJ, Campbell DA, Pierce RJ. A longitudinal evaluation of sleep and breathing in the first year after cervical spinal cord injury. Arch Phys Med Rehabil. 2005;86:1193–1199
  5. Pokorski M, Morikawa T, Takaishi S, Masuda A, Ahn B, Honda Y. Ventilatory response to chemosensory stimuli in quadriplegic subjects. Eur Respir J. 1990;3:891–900
  6. Wasicko MJ, Hutt DA, Parisi RA, Neubauer JA, Mezrich R, Edelman NH. The role of vascular tone in the control of upper airway collapsibility. Am Rev Respir Dis. 1990;141:1569–1577
  7. McEvoy RD, Mykytyn I, Sajkov D, et al. Sleep apnoea in patients with quadriplegia. Thorax. 1995;50:613–619
  8. Mollinger LA, Spurr GB, El Ghatit AZ, et al. Daily energy expenditure and basal metabolic rates of patients with spinal cord injury. Arch Phys Med Rehabil. 1985;66:420–426
  9. Ayas NT, Epstein LJ, Brown R, Hibbert AM, Garshick E. Baclofen use and age can predict obstructive sleep apnea in spinal cord injury. Sleep. 1999;22(Suppl):294–295
  10. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–1235
  11. Klefbeck B, Sternhag M, Weinberg J, Levi R, Hultling C, Borg J. Obstructive sleep apnoeas in relation to severity of cervical spinal cord injury. Spinal Cord. 1998;36:621–628
  12. Stockhammer E, Tobon A, Michel F, et al. Characteristics of sleep apnoea syndrome in tetraplegic patients. Spinal Cord. 2002;40:286–294
  13. Flavell H, Marshall R, Thornton AT, Clements PL, Antic R, McEvoy RD. Hypoxia episodes during sleep in high tetraplegia. Arch Phys Med Rehabil. 1992;73:623–627
  14. Burns SP, Little JW, Hussey JD, Lyman P, Lakshminara-Yanan S. Sleep apnoea syndrome in chronic spinal cord injury: associated factors and treatment. Arch Phys Med Rehabil. 2000;81:1334–1339
  15. Cahan L, Gothe B, Decker MJ, Arnold JL, Strohl KP. Arterial oxygen saturation over time and sleep studies in quadriplegic patients. Paraplegia. 1993;31:172–179
  16. Short DJ, Stradling JR, Williams SJ. Prevalence of sleep apnoea in patients of 40 years of age with spinal cord lesions. J Neurol Neurosurg Psychiatry. 1992;55:1032–1036
  17. American Spinal Injury Association/International Medical Society of Paraplegia. International standards for neurological and functional classification of spinal cord injury patients. Chicago: ASIA/IMSP; 2000;
  18. Report of an American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22:667–689
  19. Leduc BE, Lepage Y. Health-related quality of life after spinal cord injury. Disabil Rehabil. 2002;24:196–202
  20. Frankel HL, Coll JR, Charlifue SW, et al. Long-term survival in spinal cord injury: a fifty year investigation. Spinal Cord. 1998;36:266–274
  21. Epstein LE, Garshick E, Ayas N, et al. Sleep-disordered breathing in spinal cord injured patients. [abstract] J Spinal Cord Med. 2000;23:194
  22. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14:540–545
  23. Johns MW, Hocking B. Daytime sleepiness and sleep habits of Australian workers. Sleep. 1997;20:844–849
  24. Walsleben JA, Kapur VK, Newman AB, et al. Sleep and reported daytime sleepiness in normal subjects: the Sleep Heart Health Study. Sleep. 2004;27:293–298
  25. Ben-Noun L, Sohar E, Laor A. Neck circumference as a simple screening measure for identifying overweight and obese patients. Obesity Res. 2001;9:470–477
  26. American Thoracic Society consensus conference. Indications and standards for cardiopulmonary sleep studies. Am Rev Respir Dis. 1989;139:559–568
  27. American Academy of Sleep Medicine. The international classification of sleep disorders, revised, diagnostic and coding manual. Rochester: Davies Printing; 1997;
  28. American Sleep Disorders Association Report. EEG arousals: scoring rules and examples. Sleep. 1992;15:173–184
  29. Hosmer DW, Lemeshow S. Applied logistic regression. New York: Wiley; 1989;
  30. Fry JM, DiPhilippo MA, Curran K, Goldberg R, Sinan Baron N. Full polysomnography in the home. Sleep. 1998;21:635–642
  31. Jones LM, Legge M, Goulding A. Healthy body mass index values often underestimate body fat in men with spinal cord injury. Arch Phys Med Rehabil. 2003;84:1068–1071
  32. Maislin G, Pack AI, Kribbs NB, et al. A survey screen for prediction of apnea. Sleep. 1995;18:158–166
  33. Yamada KA, Hamosh P, Gillis RA. Respiratory depression produced by activation of GABA receptors in hindbrain of cat. J Appl Physiol. 1981;5:1278–1286
  34. Burns SP, Kapur V, Yin KS, Buhrer R. Factors associated with sleep apnea in men with spinal cord injury: a population-based case-control study. Spinal Cord. 2001;39:15–22
  35. Engleman HM, Hirst WS, Douglas NJ. Under reporting of sleepiness and driving impairment in patients with sleep apnea/hypopnea syndrome. J Sleep Res. 1997;6:272–275
  36. Sangal RB, Young R. The Epworth sleepiness scale does not measure perceived sleepiness in patients with sleep apnea. [abstract] Sleep. 2003;26(Suppl):A211–A212
  37. Burns SP, Yavari Rad M, Bryant S, Kapur V. Long-term treatment of sleep apnea in persons with spinal cord injury. Am J Phys Med Rehabil. 2005;84:620–626
  38. American Academy of Sleep Medicine. In: International classification of sleep disorders: diagnostic and coding manual. 2nd ed.. Westchester: American Academy of Sleep Medicine; 2005;p. 54

 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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