Continuous Positive Airway Pressure Use for Obstructive Sleep Apnea in Acute, Traumatic Tetraplegia.
Arch Phys Med Rehabil
; 100(12): 2276-2282, 2019 12.
Article
in En
| MEDLINE
| ID: mdl-31421094
ABSTRACT
OBJECTIVE:
To describe continuous positive airway pressure (CPAP) use for treatment of obstructive sleep apnea (OSA) in acute tetraplegia, including adherence rates and associated factors.DESIGN:
Secondary analysis of CPAP data from a multinational randomized controlled trial.SETTING:
Inpatient rehabilitation units of 11 spinal cord injury centers.PARTICIPANTS:
People with acute, traumatic tetraplegia and OSA (N=79).INTERVENTIONS:
Autotitrating CPAP for OSA for 3 months. MAIN OUTCOMEMEASURES:
Adherence measured as mean daily hours of use. Adherent (yes/no) was defined as an average of at least 4 hours a night throughout the study. Regression analyses determined associations between baseline factors and adherence. CPAP device pressure and leak data were analyzed descriptively.RESULTS:
A total of 79 participants from 10 spinal units (91% men; mean age ± SD, 46±16; 78±64d postinjury) completed the study in the treatment arm and 33% were adherent. Mean daily CPAP use ± SD was 2.9±2.3 hours. Better adherence was associated with more severe OSA (P=.04) and greater CPAP use in the first week (P<.01). Average 95th percentile pressure was low (9.3±1.7 cmH2O) and 95th percentile leak was high (27.1±13.4 L/min).CONCLUSION:
Adherence to CPAP after acute, traumatic tetraplegia is low. Early acceptance of therapy and more severe OSA predict CPAP use over 3 months. People with acute tetraplegia require less pressure to treat their OSA than the nondisabled; however, air leak is high. These findings highlight the need for further investigation of OSA treatment in acute tetraplegia.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Quadriplegia
/
Spinal Cord Injuries
/
Sleep Apnea, Obstructive
/
Continuous Positive Airway Pressure
Type of study:
Clinical_trials
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Arch Phys Med Rehabil
Year:
2019
Document type:
Article