Abstract
Burns SP, Little JW, Hussey JD, Lyman P, Lakshminarayanan S. Sleep apnea syndrome
in chronic spinal cord injury: associated factors and treatment. Arch Phys Med Rehabil
2000;81:1334-9. Objective: To determine the prevalence of sleep apnea in a sample of persons with chronic spinal
cord injury (SCI) of varying injury levels and degrees of impairment. Design: Cross-sectional study. Setting: Inpatient SCI rehabilitation unit. Participants: Twenty men with SCI (motor complete and incomplete; American Spinal Injury Association
classes A–D) of at least 1 year's duration, randomly selected from patients with SCI
undergoing elective hospitalization. Main Outcome Measures: Apnea index, determined by sleep study (including chest wall movement, airflow, oxygen
saturation), and daytime sleepiness, determined by Epworth sleepiness score. Results: Eight subjects (40%) had sleep apnea, manifested by elevated apnea index (mean ±
SD, 17.1 ± 6.9) and excessive daytime sleepiness. Sleep apnea was commonly diagnosed
in motor-incomplete injuries. A trend (p =.07) existed toward a greater prevalence of sleep apnea with tetraplegia. Age and
body mass index were not associated with sleep apnea. Conclusion: The prevalence of sleep apnea in men with chronic SCI admitted for nonrespiratory
elective hospitalization is high relative to the general population. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The occurrence of sleep-disordered breathing among middle-aged adults.N Engl J Med. 1993; 328: 1230-1235
- Oxygen saturation during sleep in patients with spinal cord injury.Am J Phys Med. 1982; 61: 302-309
- Hypoxia episodes during sleep in high tetraplegia.Arch Phys Med Rehabil. 1992; 73: 623-627
- Arterial oxygen saturation over time and sleep studies in quadriplegic patients.Paraplegia. 1993; 31: 172-179
- Prevalence of sleep apnoea in patients over 40 years of age with spinal cord lesions.J Neurol Neurosurg Psychiatry. 1992; 55: 1032-1036
- Sleep apnoea in patients with quadriplegia.Thorax. 1995; 50: 613-619
- Obstructive sleep apneas in relation to severity of cervical spinal cord injury.Spinal Cord. 1998; 36: 621-628
- Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth sleepiness scale.Chest. 1993; 103: 30-36
- Automobile accidents involving patients with obstructive sleep apnea.Am Rev Respir Dis. 1988; 138: 337-340
- The association between sleep apnea and the risk of traffic accidents.N Engl J Med. 1999; 340: 847-851
- Sleep apnoea related hypoxia is associated with cognitive disturbances in patients with tetraplegia.Spinal Cord. 1998; 36: 231-239
- Pulmonary hypertension in patients with obstructive sleep apnea syndrome.Arch Intern Med. 1997; 157: 2483-2487
- Mortality in sleep apnea patients: a multivariate analysis of risk factors.Sleep. 1995; 18 (comments]): 149-157
- Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome.Am Rev Respir Dis. 1988; 138: 345-349
- Use of the Epworth sleepiness scale to demonstrate response to treatment with nasal continuous positive airways pressure in patients with obstructive sleep apnoea.Respir Med. 1995; 89: 617-620
- Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome.Lancet. 1994; 343: 572-575
- Oxygen desaturations during exercise and sleep in fit tetraplegic patients.Arch Phys Med Rehabil. 1998; 79: 800-804
- International standards for neurological and functional classification of spinal cord injury, revised 1996.American Spinal Injury Association, Chicago (IL)1996
- The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia.I. Paraplegia. 1969; 7: 179-192
- Treatment of sleep apnoea in spinal cord injured patients.Paraplegia. 1995; 33: 271-273
- A new method for measuring daytime sleepiness: the Epworth sleepiness scale.Sleep. 1991; 14: 540-545
- Recent demographic and injury trends in people served by the Model Spinal Cord Injury Care Systems.Arch Phys Med Rehabil. 1999; 80: 1372-1382
- Reliability and factor analysis of the Epworth sleepiness scale.Sleep. 1992; 15: 376-381
- Measurement of sleep-related breathing disturbances in epidemiologic studies. Assessment of the validity and reproducibility of a portable monitoring device.Chest. 1991; 100: 1281-1286
- Recognition and consequences of obstructive sleep apnea hypopnea syndrome.Clin Chest Med. 1998; 19: 1-19
- The international classification system of sleep disorders: diagnostic and coding manual.American Sleep Disorders Association, Rochester (MN)1990
- What is hypopnea, anyway?.Chest. 1994; 105: 426-428
- Monitoring sleep and breathing: methodology. Part I: monitoring breathing.Clin Chest Med. 1998; 19: 203-212
- The epidemiology of spinal cord injury.in: Spinal cord injury. Aspen, Gaithersburg (MD)1995: 100-119 (Clinical outcomes from the model systems)
- A limited diagnostic investigation for obstructive sleep apnea syndrome. Oximetry and static charge sensitive bed.Chest. 1990; 98: 1341-1345
- Sleep state effects on breathing after spinal cord transection and vagotomy in the cat.Respir Physiol. 1979; 37: 89-100
- Self-reported use of CPAP and benefits of CPAP therapy: a patient survey.Chest. 1996; 109 ([comments]): 1470-1476
- The Stockholm spinal cord injury study: 1. Medical problems in a regional SCI population.Paraplegia. 1995; 33: 308-315
- Alcohol, snoring and sleep apnea.J Neurol Neurosurg Psychiatry. 1982; 45: 353-359
- Risk factors in a general population for snoring. Importance of cigarette smoking and obesity.Chest. 1988; 93: 678-683
- Body composition of spinal cord injured adults.Sports Med. 1997; 23: 48-60
- Nutritional assessment of the spinal cord injured patient.J Am Diet Assoc. 1981; 78: 501-505
- The effects of the GABA agonist, baclofen, on sleep and breathing.Eur Respir J. 1995; 8: 230-234
- Neonatal chest wall afferents and regulation of respiration.J Appl Physiol. 1977; 42: 362-367
- Positional vs nonpositional obstructive sleep apnea patients: anthropomorphic, nocturnal polysomnographic, and multiple sleep latency test data.Chest. 1997; 112: 629-639
- Long-term acceptance of continuous positive airway pressure in obstructive sleep apnea.Am Rev Respir Dis. 1991; 144: 1130-1133
- Long-term compliance with nasal continuous positive airway pressure (CPAP) in obstructive sleep apnea patients and nonapneic snorers.Sleep. 1992; 15: S42-S46
Article info
Publication history
Accepted:
March 17,
2000
Received in revised form:
March 17,
2000
Footnotes
☆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 authors or upon any organization with which the authors are associated.
☆☆Reprint requests to Stephen P. Burns, MD, SCI Service (128), VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, e-mail: [email protected]
★Suppliers
Identification
Copyright
© 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
