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Continuous positive airway pressure requirements in patients with tetraplegia and obstructive sleep apnoea.
MedLine Citation:
PMID:  22614126     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study design:Clinic-based retrospective case-control study.Objectives:To compare continuous positive airway pressure (CPAP) requirements between patients with tetraplegia and able-bodied patients with obstructive sleep apnoea (OSA).Setting:Melbourne, Australia.Methods:Diagnostic and CPAP titration polysomnograms of 219 able-bodied, and 25 patients with tetraplegia and OSA were compared for apnoea hypopnoea index (AHI) and CPAP levels required to effectively treat OSA. Demographics and body mass index (BMI) were obtained for each patient. ASIA score and injury date were obtained for patients with tetraplegia.Results:There was no significant difference in AHI (P=0.102) between the two groups; however, able-bodied patients were significantly older (P=0.003), required significantly higher levels of CPAP to control their OSA (P<0.001) and had higher BMIs (P=0.009) than patients with tetraplegia. In the tetraplegia group, there was no significant correlation between AHI and effective CPAP (r=0.022, P=0.92) or between AHI and BMI (r=-0.196, P=0.35). There was a significant correlation between effective CPAP and BMI (r=0.411, P=0.041). Among able-bodied patients, over two-thirds (68.8%) required 10-16 cm H(2)0 to control their OSA and nearly one-third required over 16 cm H(2)0. In contrast, over two-thirds (68.8%) in the tetraplegia group required less than 10 cm H(2)0 of CPAP to control their OSA.Conclusion:This retrospective study suggests that OSA patients with tetraplegia require significantly less CPAP to treat their OSA at any given AHI than those who are able-bodied. This suggests that additional unknown factors may contribute to the high prevalence of OSA in tetraplegia.Spinal Cord advance online publication, 22 May 2012; doi:10.1038/sc.2012.57.
Authors:
M C Le Guen; P A Cistulli; D J Berlowitz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-22
Journal Detail:
Title:  Spinal cord     Volume:  -     ISSN:  1476-5624     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1] Bowen Centre, Austin Health, Institute for Breathing and Sleep, Melbourne, Victoria, Australia [2] Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
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