Sleep disordered breathing in spinal cord injury: A systematic review

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1080/10790268.2015.1126449 · Published: July 1, 2016

Spinal Cord Injury Sleep Medicine Pulmonology

Simple Explanation

Spinal cord injuries can lead to muscle weakness affecting breathing, potentially increasing the risk of sleep-disordered breathing. Sleep disordered breathing is when someone stops breathing or has shallow breaths during sleep. This is more common in people with spinal cord injuries. It's important to identify and treat sleep-disordered breathing in individuals with spinal cord injuries to prevent further health issues.

Study Duration

1980 to 2013 (search period)

Participants

Varies across studies; some studies included 30-50 participants with SCI

Evidence Level

Systematic Review

Key Findings

1
Sleep-disordered breathing is prevalent in individuals with spinal cord injuries, especially those with motor-complete tetraplegia.
2
Central sleep apnea is more common in patients with tetraplegia compared to those with paraplegia.
3
Symptoms of sleep-disordered breathing don't always correlate with the severity of the condition in SCI patients, making formal sleep studies crucial.

Research Summary

This systematic review examines the incidence, prevalence, and characteristics of sleep-disordered breathing (SDB) in individuals with spinal cord injury (SCI). The review highlights the high prevalence of SDB in SCI patients, particularly those with tetraplegia, and emphasizes the importance of differentiating between obstructive and central sleep apnea due to differing treatment approaches. The authors conclude that early sleep studies are essential for patients with complete tetraplegia, and that further research is needed to determine the best methods for evaluating and treating SDB in this population.

Practical Implications

Early Screening

Implement early and routine screening for sleep-disordered breathing in patients with acute complete tetraplegia.

Personalized Treatment

Tailor treatment approaches based on the type of sleep apnea (obstructive vs. central) and individual patient characteristics.

Further Research

Conduct further research to identify optimal evaluation methods, treatment criteria, and long-term outcomes of SDB treatment in SCI patients.

Study Limitations

1
Limited sample sizes in many studies
2
Variations in study populations regarding age, time since injury, and neurological level
3
Lack of studies comparing home and sleep lab results in persons with spinal cord injury

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