Subjective sleep disturbances and quality of life in chronic tetraplegia

Abstract

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.

Is the Use of Growth hormone and Melatonin Justified in Spinal Cord Injuries?

“…Similar conclusions have been reported in other studies in which the poor sleep efficiency has been related to sleep apneas and neuromuscular weakness that negatively affects respiratory function [41][42][43]. In any case, people with tetraplegia suffer sleep problems and poor quality of life [44]; moreover, these problems associated to the increased metabolic disorders (as described in the Introduction) place them in an increased risk for suffering stroke or myocardial infarction. Despite that a pilot clinical trial [45], carried out in eight patients with tetraplegia and absence of MT production, in which sleep disorders existed, showed that treating them with 8 mg of the MT agonist Ramelteon did not produce significant effects on the existing sleep problems, we think that the reported multiple beneficial effects of MT, and the absence of any adverse effect that it might produce, make this hormone useful when treating SCI patients.…”

Actigraphy-based evaluation of sleep quality and physical activity in individuals with spinal cord injury

“…Sleep is an essential physiological need that has a critical role for general health. Sleep disturbances are more frequently reported among individuals with spinal cord injury (SCI) compared to healthy individuals, and are associated with negative health outcomes, poor quality of life [1][2][3][4].…”

Quality of Life after Spinal Cord Injury: A Multiple Case Study Examination of Elite Athletes

“…P1’s score may be associated with poor health in the last four weeks, and the WHOQoL scale refers to this period of time. People with chronic tetraplegia experience more subjective sleep problems and worse quality of life than their able-bodied counterparts [ 39 ]. A study involving 270 individuals who sustained SCI found that poorer QoL was associated with secondary impairments (for example, neuropathic pain, urinary tract infection), activity limitations, and participation restrictions, but not with neurological level, completeness of injury, age, or time since injury [ 11 ].…”