Oxygen Saturation During Sleep in Patients With Spinal Cord Injury1

Braun, Sheldon R.; Giovannoni, Rita M.; Levin, Allan B.; Harvey, Richard F.

doi:10.1097/00002060-198212000-00003

Cited by 29 publications

(11 citation statements)

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“…The present results on lung function parameters in Table II confirm several previous investigations in tetraplegics (Bergofsky, 1964, Braun et al, 1982, Cameron et aI., 1955, Forner, 1980, Fugl-Meyer and Grimby, 1971, Haas et al, 1985Huldtgren et al, 1980, Ledsome and Sharp, 1961, Maloney 1979, McKinley et al, 1969, Ohry et al, 1975, Stone and Keltz, 1963 demonstrating a pronounced restrictive ventilatory impairment, not least caused by altered mechanical properties of the chest wall as a result of the paralysis (Fugl-Meyer and Grimby, 1984).…”

Section: Discussionsupporting

confidence: 92%

Effect of respiratory training with a mouth-nose-mask in tetraplegics

et al. 1991

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SummaryTen tetraplegics, 8 males and 2 females, with a median age of 32 years participated in a scheduled 6 weeks training programme with a respiratory muscle training mouth-nose mask (RM T -mask) with a fixed expiratory and an increasing inspiratory resistance set by the tetraplegic in accordance to hisl her increasing ability during the training period. During the 6 weeks the tetraplegics required to use the RMT-mask for 15 minutes three times a day. Before and after each training session they measured peak flow (PEF). Lung volumes, ventilatory and diffusion capacity were measured before and after the 6 weeks training period. The training resulted only in a significant change in the PEF, which increased with 11% from 371 II min before to 412 IImin in average after the 6 weeks of training (p < 0'025). This statistically significant increase was confirmed by the measurements of PEF performed by the tetraplegics themselves during the training period. In addition there was an increase in PEF from before to immediately after each 15 minutes training session, this trend reached statistically significance (p < 0'025) in the third '2 weeks period'. These results might indicate a possibility of improving the tetraplegics ability to cough by use of a simple RMT-mask, which in turn might prevent certain lung complications including pneumonia, and atelectasia.

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Section: Discussionsupporting

confidence: 92%

Effect of respiratory training with a mouth-nose-mask in tetraplegics

et al. 1991

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“…49 Likewise, it has been found that a large segment of the tetraplegics, not least those of older age, may be at risk of potentially serious nocturnal hypoxic episodes, 5,6,9,10 in particular when there is diaphragmatic dysfunction. 8 Sleep related hypoxia may be associated with cardiovascular events and a risk of stroke, 50 and cognitive disturbances in patients with tetraplegia. 12 It was a little surprising that only a few in the SCI population reported decreased ability to change position as a sleep problem because many SCI individuals mostly sleep supine, and this position has been shown to be associated with sleep disordered breathing.…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbances in the spinal cord injured: an epidemiological questionnaire investigation, including a normal population

2001

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Study design: Epidemiological review. Objective: To evaluate sleep disturbances in the spinal cord injured. Setting: The Clinic for Para-and Tetraplegia, Hornbñk/Copenhagen, Copenhagen University hospital, Denmark. Methods: All patients admitted with traumatic SCI during the 20-year period 1968 ± 1987 were reviewed. The normal population consisted of 339, 222 men and 117 women. These groups were asked to ®ll in the self-administered Nordic Sleep Questionnaire (NSQ) containing 21 questions. Questions were added regarding employment, smoking, alcohol, co ee or tea consumption, height and weight. The questionnaire for SCI individuals included questions about bladder emptying method, mobility, and spasms. For the SCI population age at injury, cause of injury, neurological level, and functional class were retrieved. Results: Four hundred and eight SCI individuals, 331 men and 77 women, answered the NSQ corresponding to a response rate of 83.8%. Forty-seven per cent had a cervical cord lesion and about half of the population had a complete motor lesion. In comparison with the normal population the SCI individuals had greater di culty in falling asleep, described more frequent awakenings, slept subjectively less well, were more often prescribed sleeping pills, slept more hours, took more and longer naps, and snored more and for more years. In particular, spasms, pain, paraesthesia, and troubles with voiding were claimed to be part of the sleep problems. Conclusion: In spite of the same average age and a higher body mass index in the normal than the SCI population, the SCI individuals showed signi®cantly more sleep problems than the normal population. Spinal Cord (2001) 39, 505 ± 513

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“…The prevalence of sleep apnea in higher level paraplegics could be similar to lower level tetraplegics, but too few paraplegic patients have been included in prior studies to assess this. 1,3,4,8 This study examined the relationship between sleep apnea and neurological classi®cation for motor level and ASIA Impairment Scale. The case-control portion showed a motor level of C5 or above to be associated with sleep apnea.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,8 Prior studies have either excluded paraplegic subjects 2,5 ± 7 or included a small number of them. 1,3,4,8 The majority of studies have excluded subjects with American Spinal Injury Association (ASIA) Impairment Scale (AIS) scores 9 or Frankel scores 10 of D 1,2,4,5,7 or have not reported ASIA or Frankel scores. subjects with sleep apnea.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with sleep apnea in men with spinal cord injury: a population-based case-control study

et al. 2001

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Objective: To characterize a population of spinal cord injury (SCI) patients with sleep apnea, and to determine associated factors and comorbidities Study Design: Population-based retrospective case-control study. Subjects: 584 male patients served by a Veterans Aairs SCI service. Measures: Medical records were reviewed for sleep apnea diagnosis, demographic information, neurologic characteristics, and treatments received. Sleep study reports were not available to determine the nature of abnormal respiratory events (ie central, obstructive, hypoventilation). For each case with tetraplegia, a control tetraplegic subject without sleep apnea diagnosis was selected. Results: We identi®ed 53 subjects with diagnosed sleep apnea: 42 tetraplegic, 11 paraplegic. This represented 14.9% of all tetraplegic and 3.7% of all paraplegic patients in the population (P50.0001 for comparison of tetraplegic and paraplegic proportions). In tetraplegic subjects, sleep apnea was associated with obesity and more rostral motor level, but not with ASIA Impairment Scale. Medical comorbidities associated with sleep apnea in non-SCI patients, such as hypertension, were more common in case subjects. Less than half of case subjects were receiving some form of treatment. For motor-complete tetraplegics, long-term positive airway pressure treatment was less common with motor level C5 and above compared to C6 and below. Conclusion: In this population, sleep apnea has been frequently diagnosed, particularly in tetraplegic subjects. The true prevalence is likely to be considerably higher, since this study considered only previously diagnosed cases. Sleep apnea was associated with obesity and higher neurologic level, but not ASIA Impairment Scale. Medical comorbidities were more frequent in this group, and treatment acceptance was poor with higher level motor-complete injuries. Since the type of sleep apnea (central or obstructive) was not distinguished, we cannot comment on the prevalence and associations based on speci®c types of sleep apnea. Spinal Cord (2001) 39, 15 ± 22

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Oxygen Saturation During Sleep in Patients With Spinal Cord Injury1

Cited by 29 publications

References 0 publications

Effect of respiratory training with a mouth-nose-mask in tetraplegics

Effect of respiratory training with a mouth-nose-mask in tetraplegics

Sleep disturbances in the spinal cord injured: an epidemiological questionnaire investigation, including a normal population

Factors associated with sleep apnea in men with spinal cord injury: a population-based case-control study

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