Original articleEstimated Prevalence of Obstructive Sleep Apnea–Hypopnea Syndrome After Cervical Cord Injury
Section snippets
Participants
After approval of this research project by the Research Ethics Committee, we recruited participants at the Outpatient Clinic of the Institut de Réadaptation de Montréal without any prior advertising or postings and without selecting patients on the basis of symptoms that could suggest sleep apnea; our intention was thus to avoid a possible bias in assessing the prevalence of OSAHS. Patients were invited to participate in the study during their medical examination if they fulfilled the following
Participants
From the 73 subjects approached, 15 declined to participate, and 4 were excluded for various reasons (1 subject already diagnosed with OSAHS, 2 lived too far, 1 had a multiresistant bacterial infection). Of the 54 subjects recruited, 13 did not complete the study, in 1 case because of a too brief total sleep time (<4h), and 12 subjects abandoned the study (loss of interest or additional illness translating into refusal to submit to polysomnography). Therefore, 41 participants were studied;
Discussion
Considering our study population representative of the general population of our area, because all patients from this population with an SCI from all causes are treated at the Institut de Réadaptation de Montréal, the current study suggests a high prevalence of OSAHS in subjects with a cervical SCI compared with the general population and concurs with previous investigations that actually prove comparable in terms of sample type and size and the use of polysomnography.7, 9, 12, 15, 21
Conclusions
Using specific diagnostic criteria, the results of our study in 41 participants with post-traumatic tetraplegia suggest a high prevalence of OSAHS, much greater than in the general population. OSAHS should be suspected and looked for, particularly in patients with tetraplegia presenting daytime sleepiness, obesity, and frequent awakenings during sleep.
Acknowledgments
We thank Vincent Jobin, MD, FRCPC, Respiratory Division, Centre Hospitalier de l’Université de Montréal (CHUM), for his contribution to the study analysis, Benoît Dulong, Department of Mathematics and Statistics, Université de Montréal, for the data analysis, and the 3 sleep technicians who carried out the polysomnographic recordings: Marie-France Gilbert, Fanny Morin, and Manon Robert. The editorial assistance of Ovid Da Silva, Research Support Office, CHUM Research Centre, is acknowledged.
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2020, Australian Critical CareSleep-Disordered Breathing and Spinal Cord Injury: A State-of-the-Art Review
2019, ChestCitation Excerpt :Improved acute care after traumatic injury has resulted in increased survival for patients with SCI/D and increased likelihood of experiencing chronic diseases common in middle-aged and older adults. Several studies, mostly single-site case series, have found a high prevalence of SDB in patients with subacute and chronic spinal cord injury (SCI) (range, 27%-82%).3-6 The variability in estimated prevalence is related to multiple factors, including different diagnostic methods, (ie, polysomnography, home sleep apnea testing [HSAT], nocturnal oximetry), different definitions of respiratory events, and different thresholds for defining SDB (Table 1).7-16
Daytime sleepiness and its relationships to fatigue and autonomic dysfunction in adults with spinal cord injury
2018, Journal of Psychosomatic ResearchCitation Excerpt :Daytime sleepiness is the propensity to fall asleep during the day and linked to problems such as reduced productivity [3, 9–11]. It is prevalent in tetraplegia and complete lesions, and sleep disturbance increases daytime sleepiness and vice versa [9, 10]. Chronic fatigue is also a substantial problem in adults with SCI [5, 8, 12] and defined as excessive chronic tiredness involving feelings of exhaustion and negative emotions, such as anxiety and poor mood [11].
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2018, Clinics in Chest MedicineCitation Excerpt :The medication was well tolerated, and no adverse events were reported. The prevalence of sleep-disordered breathing among subjects with tetraplegia has been reported to be as high as 83% in the first year following injury,126 and among those with chronic injury in the range of 27% to 77%.127–133 Reports of obstructive sleep apnea (OSA) predominate in the literature, although a recent investigation suggested a high prevalence of central apnea.131
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