Intensive support does not improve positive-airway pressure use in spinal cord injury/disease: a randomized clinical trial.
Sleep
; 47(5)2024 May 10.
Article
em En
| MEDLINE
| ID: mdl-38422375
ABSTRACT
STUDY OBJECTIVE:
Treatment of sleep-disordered breathing (SDB) with positive airway pressure (PAP) therapy has unique clinical challenges in individuals living with spinal cord injuries and diseases (spinal cord injury [SCI]/D). Interventions focused on increasing PAP use have not been studied in this population. We aimed to evaluate the benefits of a program to increase PAP use among Veterans with SCI/D and SDB.METHODS:
Randomized controlled trial comparing a behavioral Intervention (nâ =â 32) and educational control (nâ =â 31), both including one face-to-face and five telephone sessions over 3 months. The intervention included education about SDB and PAP, goal setting, troubleshooting, and motivational enhancement. The control arm included non-directive sleep education only.RESULTS:
Primary outcomes were objective PAP use (nights ≥4 hours used within 90 days) and sleep quality (Pittsburgh Sleep Quality Index [PSQI] at 3 months). These did not differ between intervention and control (main outcome timepoint; mean difference 3.5 [-9.0, 15.9] nights/week for PAP use; pâ =â .578; -1.1 [-2.8, 0.6] points for PSQI; pâ =â .219). Secondary outcomes included fatigue, depression, function, and quality of life. Only fatigue improved significantly more in the intervention versus the control group (pâ =â .025). Across groups, more PAP use was associated with larger improvements in sleep quality, insomnia, sleepiness, fatigue, and depression at some time points.CONCLUSIONS:
PAP use in Veterans with SCI/D and SDB is low, and a 3-month supportive/behavioral program did not show significant benefit compared to education alone. Overall, more PAP use was associated with improved symptoms suggesting more intensive support, such as in-home assistance, may be required to increase PAP use in these patients. CLINICAL TRIALS INFORMATION Title "Treatment of Sleep Disordered Breathing in Patients with SCI." Registration number NCT02830074. Website https//clinicaltrials.gov/study/NCT02830074?cond=Sleep%20Apnea&term=badr&rank=5.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Síndromes da Apneia do Sono
/
Traumatismos da Medula Espinal
/
Veteranos
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article