Prevalences of sleep-related breathing disorders and severity factors in chronic spinal cord injury and abled-bodied individuals undergoing rehabilitation: a comparative study.

STUDY OBJECTIVES: The objective of this study is to discern distinguishing characteristics of sleep-related breathing disorders (SRBD) in individuals with chronic spinal cord injury (CSCI) compared to able-bodied participants (non-CSCI). Additionally, the study investigates factors associated with SRBD severity. METHODS: This is a cross-sectional analysis of 123 able-bodied individuals, 40 tetraplegics, and 48 paraplegics, who underwent attended or partially supervised full polysomnography, for suspected SRBD, in a rehabilitation center. Polysomnographic, transcutaneous capnography, and clinical data were collected and compared between the groups. RESULTS: Among tetraplegics prevailed apnea-hypopnea index ≥ 30 (67.5%, p=0.003), central apnea (17.5%, p=0.007), and higher oxygen-desaturation index (80.0%, p=0.01). Sleep-related hypoventilation was present in 15,4% of tetraplegics and 15,8% of paraplegics, compared to 3,2% in able-bodied participants (p=0.05). In the able-bodied and paraplegic groups, snoring and neck circumference were positively correlated with obstructive sleep apnea (OSA) severity. A positive correlation between waist circumference and OSA severity was identified in all groups, and multivariate logistic regression analysis showed that loud snoring and waist circumference had the greatest impact on OSA severity. CONCLUSIONS: Severe OSA and Central Sleep Apnea prevailed in tetraplegic participants. Sleep-related hypoventilation was more common in tetraplegics and paraplegics compared to able-bodied participants. Loud snoring and waist circumference had an impact on OSA severity in all groups. We recommend the routine implementation of transcutaneous capnography in individuals with CSCI. We underscore the significance of conducting a comprehensive sleep assessment in the rehabilitation process of individuals with CSCI.

Obstructive Sleep Apnea Treatment with Oral Appliance in a Myotonic Dystrophy Type I Subject: A Case Report.

Objective to report a myotonic dystrophy type 1 (MD1) subject with obstructive sleep apnea syndrome treated with oral appliance. Methods A review of individual's history and records, associated with a photographic register of all diagnostic methods and literature research about the topic were done. Final Statements This case depicts the therapeutical choices disposable to treat subjects with obstructive sleep apnea and DM1. Although considered an uncommon treatment, the oral appliances, if well indicated in adequately selected cases, can satisfactorily improve respiratory parameters, symptoms and quality of life.

Analysis of mean transcutaneous capnography in consecutive patients undergoing polysomnography.

UNLABELLED: Transcutaneous capnography is a noninvasive method useful for analysis of the behavioral tendency of transcutaneous CO2pressure (PtcCO2) in patients undergoing polysomnography, to evaluate respiratory sleep disorders. OBJECTIVE: Determine normative PtcCO2values in normal patients undergoing polysomnography. METHOD: One hundred seventy-nine patients who underwent polysomnography with simultaneous PtcCO2measurement were assessed by means of a transcutaneous capnograph (TCM4 series from Radiomiter). RESULTS: The group classified as normal (N=53) presented a apnea/hypopnea index (AHI) <5 events/per hour of sleep and their age groups varied between 7 and 76 years of age. CONCLUSION: Global mean values of PtcCO2in the normal group had a Gaussian distribution that varied between 33.1 and 50.0 mmHg (SD 4,363). Such findings allowed the establishment of normative PtcCO2values for normal individuals.

Analysis of mean transcutaneous capnography in consecutive patients undergoing polysomnography / Análise da capnografia transcutânea média em indivíduos consecutivamente submetidos à polissonografia

Transcutaneous capnography is a noninvasive method useful for analysis of the behavioral tendency of transcutaneous CO2 pressure (PtcCO2) in patients undergoing polysomnography, to evaluate respiratory sleep disorders. Objective Determine normative PtcCO2 values in normal patients undergoing polysomnography. Method One hundred seventy-nine patients who underwent polysomnography with simultaneous PtcCO2 measurement were assessed by means of a transcutaneous capnograph (TCM4 series from Radiomiter). Results The group classified as normal (N=53) presented a apnea/hypopnea index (AHI) <5 events/per hour of sleep and their age groups varied between 7 and 76 years of age. Conclusion Global mean values of PtcCO2 in the normal group had a Gaussian distribution that varied between 33.1 and 50.0 mmHg (SD 4,363). Such findings allowed the establishment of normative PtcCO2 values for normal individuals. .

A capnografia transcutânea é um método não invasivo útil para análise da tendência comportamental da pressão de CO2 transcutânea (PtcCO2)1,2,3 em pacientes submetidos à polissonografia para análise de transtornos respiratórios do sono. Objetivo Determinar valores normativos da PtcCO2 em pacientes normais submetidos à polissonografia. Método Foram analisados 179 pacientes submetidos à polissonografia com medida concomitante da PtcCO2 através de um capnógrafo transcutâneo. Resultados O grupo classificado como normal (N=53) apresentou índice de apnéia/hipopnéia (AIH) <5 eventos/hora de sono e faixa etária variando de 7 a 76 anos. Conclusão Os valores da média global da PtcCO2 no grupo normal apresentaram distribuição gaussiana variando de 33,1 a 50,0 mmHg (DP 4.363). Tais achados permitiram a criação de valores normativos da PtcCO2 para indivíduos normais. .