0
Sleep Disorders |

Home-Based Diagnosis of Sleep-Disordered Breathing Complicating Spinal Cord Injury

Kristy Bauman, MD; Armando Kurili, BS; Gianna Rodriguez, MD; Anthony Chiodo, MD; Helena Schotland, MD; Robert Sitrin, MD
Author and Funding Information

University of Michigan, Ann Arbor, MI


Chest. 2013;144(4_MeetingAbstracts):997A. doi:10.1378/chest.1703485
Text Size: A A A
Published online

Abstract

SESSION TITLE: Sleep Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Individuals with spinal cord injury (SCI) commonly suffer from sleep-disordered breathing due to obstructive sleep apnea (OSA) or nocturnal hypoventilation (NH) from respiratory muscle weakness. Standard polysomnograms (PSG) reliably diagnose OSA, but carbon dioxide (pCO2) measurements are not performed routinely, and SCI patients often have difficulty accessing sleep centers. We sought to determine the prevalence of OSA and NH in SCI patients, utilizing concurrent in-home PSG and transcutaneous capnography. Additionally, we examined the reliability of common clinical predictors for OSA or NH.

METHODS: Adults with C1-T6 SCI were studied prospectively. Anthropometric data, Epworth sleepiness scale (ESS), and spirometry were measured at baseline. An in-home, unsupervised overnight PSG (Stardust II class III system, Phillips Respironics) was performed concurrently with transcutaneous pCO2/SpO2 monitoring (SenTec AG, Therwil, Switzerland).

RESULTS: 35 studies were performed successfully. 7 PSG and 4 capnography studies were repeated due to technical problems. 31 subjects (88.6%) had OSA, as defined by an obstructive apnea hypopnea index (OAHI) of ≥ 5 events/hr of recording time (mean 20.7; range 5.4-60). Twelve (34.3%) subjects had NH (transcutaneous pCO2 ≥ 50mmHg for ≥ 5% study time) for a mean of 31.6% of the study time (range 5-99%). Oxygen desaturation (SpO2 ≤ 88% for ≥ 5% of study time) was detected in 7 (20%). The OAHI correlated with neck circumference (p = 0.004) and waist circumference (p = 0.028). ESS, BMI, and forced vital capacity (FVC) did not correlate with OAHI or NH.

CONCLUSIONS: Home-based PSG/transcutaneous capnography is an effective approach for diagnosing OSA and NH in SCI patients. OSA is common and under-recognized. Neck and waist circumference correlate with the severity of OSA, while ESS, FVC and O2 desaturation do not.

CLINICAL IMPLICATIONS: Home-based unsupervised PSG/transcutaneous capnography can facilitate recognition of OSA and NH, removing the obstacles associated with facility-based PSG. Future implications could include early institution of noninvasive ventilation with improved quality of life and decreased morbidity.

DISCLOSURE: The following authors have nothing to disclose: Kristy Bauman, Armando Kurili, Gianna Rodriguez, Anthony Chiodo, Helena Schotland, Robert Sitrin

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
The Authors Respond. Arch Phys Med Rehabil 2016;97(1):177-8.
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543