Relationships Between Objective Sleep Indices and Symptoms in a Community Sample of People With Tetraplegia

Berlowitz, David J; Spong, Jo; Gordon, Ian; Howard, Mark; Brown, Douglas J.

doi:10.1016/j.apmr.2012.02.016

Cited by 54 publications

(55 citation statements)

References 26 publications

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“…This study also found that sleepiness, as measured by the KSS, was related to frequent arousal from sleep and awakenings in those with complete but not incomplete tetraplegia. 5 This is consistent with other research showing a relationship with severity of sleep apnoea and daytime sleepiness. 6,17,18 Although our KSS scores may be within the normal range, the known relationship between objective sleep disturbances and daytime sleepiness suggests that therapies that treat sleep-disordered breathing could result in clinically significant improvements in sleepiness; however, this remains speculative.…”

Section: Discussionsupporting

confidence: 82%

“…2 The most common and widely studied sleep disorder in tetraplegia is obstructive sleep apnoea (OSA), with an estimated prevalence of 50-53% in the chronic population. 5,6 This is significantly higher than in the able-bodied population, which is estimated to be 9% in men and 4% in women. 7 Importantly, the presence of OSA in tetraplegia has been found to independently reduce health utility scores and thus quality of life.…”

Section: Introductionmentioning

confidence: 77%

“…Our group previously published data showing that the MAPI, which was developed for the able-bodied population to measure likelihood of OSA, has high specificity but poor sensitivity in chronic tetraplegia. 5 A comparison of MAPI scores between the able-bodied and those with tetraplegia would therefore not be valid. Further research is required to understand the predictive factors of OSA that are specific to SCI, and to develop a tool that accurately predicts both OSA and its functional impact in this population.…”

Section: Discussionmentioning

confidence: 99%

“…The relationship between these questionnaire data and objective sleep studies in a subset of this sample has been published previously. 5 …”

Section: Methodsmentioning

confidence: 99%

“…7 Importantly, the presence of OSA in tetraplegia has been found to independently reduce health utility scores and thus quality of life. 5 OSA has been associated with impaired cognition in people with tetraplegia, particularly in the areas of attention, concentration, memory and learning skills. 8 Other serious health consequences of OSA in the able-bodied population include increased risk of cardiovascular disease, diabetes and premature death.…”

Section: Introductionmentioning

confidence: 99%

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Subjective sleep disturbances and quality of life in chronic tetraplegia

et al. 2015

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Study design: This is a cross-sectional survey. Objectives: The objective of this study was to evaluate the subjective sleep disturbances and quality of life in chronic tetraplegia. Setting: This study was conducted in a community sample from Victoria, Australia. Methods: People with tetraplegia were mailed a survey battery including the following: demographic questions; Karolinska Sleepiness Scale (KSS); Basic Nordic Sleepiness Questionnaire; Functional Outcomes of Sleep Questionnaire (FOSQ); Multivariate Apnoea Prediction Index and Assessment of Quality of Life (AQoL) Questionnaire. Scores were compared with the best available normative data. Results: A total of 163 of 424 (38%) surveys were returned (77% male; 39% sensory and motor complete; mean age±s.d. = 46±14 years; mean years since injury = 11±8 years). The AQoL health utility score (0.31±0.29) was significantly lower than published population norms. FOSQ total (17.55±2.57) and KSS (3.93±2.27) scores were no different from the best available population data. People with tetraplegia reported worse sleep habits, symptoms and quality than a normal population, as indicated on 17 of 21 questions on the Basic Nordic Sleep Questionnaire. Multivariate analysis found that greater injury severity (coefficient (95% CI) = 0.14 (0.10, 0.18)), increasing age (−0.004 (−0.008, − 0.001)) and worse sleep symptoms (−0.005 (−0.009, − 0.0003)) were all significantly associated with reduced quality of life. Conclusion: People with chronic tetraplegia experience more subjective sleep problems and worse quality of life than their able-bodied counterparts. Quality of life is related to injury severity, age and sleep symptoms. Treating the sleep disorders experienced by people living with tetraplegia has the potential to improve their health and well-being.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

“…The relationship between these questionnaire data and objective sleep studies in a subset of this sample has been published previously. 5 …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subjective sleep disturbances and quality of life in chronic tetraplegia

et al. 2015

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Sleep-Disordered Breathing and Spinal Cord Injury: Challenges and Opportunities

Sankari

Martin

Badr

2017

Curr Sleep Medicine Rep

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Purpose of review This paper focuses on the sleep disorders in patients with spinal cord injury (SCI/D), particularly mechanism of sleep disordered breathing (SDB) and challenges in diagnosis and management. Based on a review of recent literatures and studies the paper summarizes some main challenges with respect to management of SDB in patients with SCI; and what are the responsible mechanisms of disease? What are the barriers in diagnosing and treating SDB using standard treatment such as positive airway pressure (CPAP)?. Recent findings Previous studies have shown that most SCI/D patients have SDB with heterogeneity in prevalence mainly related to using different definition or methods of diagnosing SDB, while recent studies using new definition of SDB based on recommended criteria from the American Academy of Sleep Medicine (AASM) and also include the data on effect of SCI/D level on prevalence and describe different type of SDB. Furthermore, recent data describes simplified method of diagnosing SDB by using a combination of home sleep apnea testing and transcutaneous CO2 monitoring. Finally, emerging data has been pointing at strong relationship between SDB and cardiovascular disease including nocturnal hypertension in patients with SCI/D. Summary The findings indicate that early testing for SDB and associated cardiovascular disease in patients with SCI is recommended and could be beneficial in reduced the high morbidity and mortality in this group of patients with disability. In addition, studies on treatment of other sleep disorders in SCI/D are not available to inform clinical decision making. Understanding the pathophysiology of sleep disorders in SCI/D is critical for the development of new effective therapies. This review provides evidence for best practices; highlights new discoveries for the diagnosis and management of sleep disorders in SCI/D, and discuss challenges and future directions.

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