Patients with spinal cord injuries should be assessed for sleep apnea

Jan. 15, 2014 A new study suggests that patients with spinal cord injuries could benefit from careful assessment for sleep apnea.

Results show that 77 percent of spinal cord injury survivors had symptomatic sleep-disordered breathing, and 92 percent had poor sleep quality. The study also found that the nature of sleep-disordered breathing in patients with spinal cord injury is complex, with a high occurrence of both obstructive and central sleep apnea events. The occurrence of central sleep apnea, which requires special consideration in diagnosis and treatment, was more common in patients with a cervical injury than in those with a thoracic injury.

"The majority of spinal cord injury survivors have symptomatic sleep-disordered breathing and poor sleep that may be missed if not carefully assessed," said principal investigator and lead author Dr. Abdulghani Sankari, physician scientist at John D. Dingell VA Medical Center and Wayne State University School of Medicine in Detroit, Mich. "Our findings help in identifying the mechanism of sleep-disordered breathing in spinal cord injury and may provide potential targets for new treatment."

The study results appear in the Jan. 15 issue of the Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine.

"Sleep-disordered breathing may contribute to increased cardiovascular mortality in spinal cord injury patients," said American Academy of Sleep Medicine President Dr. M. Safwan Badr, who was involved in the study. "All spinal cord injury patients should undergo a comprehensive sleep evaluation using full, overnight polysomnography for the accurate diagnosis of sleep apnea."

Sankari and his team studied 26 chronic spinal cord injury patients, including 15 with cervical and 11 with thoracic injuries. All subjects had baseline spirometry, a battery of questionnaires and attended polysomnography with flow and pharyngeal pressure measurements.

According to the authors, this is the first study to assess sleep-disordered breathing and ventilation changes comparing two different levels of spinal cord injury -- cervical vs. thoracic.

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Patients with spinal cord injuries should be assessed for sleep apnea