We read with great interest the article by Bauman et al
1
on the diagnosis of sleep disordered breathing (SDB) and nocturnal hypoventilation
(NH) in 91 patients with spinal cord injury (SCI). We applaud the effort of the authors
in conducting this study. Their data were obtained prospectively to assess the prevalence
of SDB and NH using home sleep apnea testing (HSAT) and transcutaneous capnography.
The authors concluded that “Unsupervised, home sleep apnea testing with transcutaneous
capnography effectively identifies SDB and NH in patients with SCI.”
1
(p1) Also, the authors speculated that “in many instances the results of a home-based
study may be sufficiently abnormal to justify appropriately and inform a prescription
for continuous or bilevel PPV.” After reading these conclusions and on the basis of
the available evidence of high prevalence of SDB and central breathing instability
in patients with tetraplegia, we wish to highlight a few areas that require further
consideration.To read this article in full you will need to make a payment
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References
- A simplified approach to diagnosing sleep disordered breathing and nocturnal hypercapnia in individuals with spinal cord injury.Arch Phys Med Rehabil. 2015; (Aug 20 [Epub ahead of print].)
- Sleep disordered breathing in chronic spinal cord injury.J Clin Sleep Med. 2014; 10: 1043
- Tetraplegia is a risk factor for central sleep apnea.J Appl Physiol (1985). 2014; 116: 345-353
- Identifying sleep disordered breathing in chronic spinal cord injury. SLEEP. 2012; 35: A285
- Sleep onset hypoventilation in chronic spinal cord injury.Physiol Rep. 2015; 3: e12490
- Identification and treatment of sleep-disordered breathing in chronic spinal cord injury.Spinal Cord. 2015; 53: 145-149
Article info
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Disclosures: none.
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Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Simplified Approach to Diagnosing Sleep-Disordered Breathing and Nocturnal Hypercapnia in Individuals With Spinal Cord InjuryArchives of Physical Medicine and RehabilitationVol. 97Issue 3
- The Authors RespondArchives of Physical Medicine and RehabilitationVol. 97Issue 1
- PreviewWe are pleased to have the opportunity to respond to these thoughtful comments. Contrary to our expectations, we found no significant correlation between the frequency of central sleep apnea events and the spinal cord injury (SCI) level in this cohort of nearly 100 individuals with SCI (appendix 1 in our original article1). At present we have no definitive explanation, but this correlation, if it exists, may be influenced by other factors such as the common use of sedating drugs, which had the greatest predictive value for central apnea events in the present study (see appendix 1 in our original article1).
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