Continuous Positive Airway Pressure Use for Obstructive Sleep Apnea in Acute, Traumatic Tetraplegia.

Graco, M; Schembri, R; Ross, J; Green, SE; Booker, L; Cistulli, PA; Ayas, NT; Berlowitz, DJ; COSAQ Investigators,

Continuous Positive Airway Pressure Use for Obstructive Sleep Apnea in Acute, Traumatic Tetraplegia.

Graco, M Schembri, R Ross, J Green, SE Booker, L Cistulli, PA Ayas, NT Berlowitz, DJ COSAQ Investigators,

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Publisher:: W B SAUNDERS CO-ELSEVIER INC
Publication Type:: Journal Article
Citation:: Arch Phys Med Rehabil, 2019, 100, (12), pp. 2276-2282
Issue Date:: 2019-12

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Field	Value	Language
dc.contributor.author	Graco, M
dc.contributor.author	Schembri, R
dc.contributor.author	Ross, J
dc.contributor.author	Green, SE
dc.contributor.author	Booker, L
dc.contributor.author	Cistulli, PA
dc.contributor.author	Ayas, NT
dc.contributor.author	Berlowitz, DJ
dc.contributor.author	COSAQ Investigators,
dc.date.accessioned	2022-09-26T03:48:43Z
dc.date.available	2019-07-22
dc.date.available	2022-09-26T03:48:43Z
dc.date.issued	2019-12
dc.identifier.citation	Arch Phys Med Rehabil, 2019, 100, (12), pp. 2276-2282
dc.identifier.issn	0003-9993
dc.identifier.issn	1532-821X
dc.identifier.uri	http://hdl.handle.net/10453/162068
dc.description.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 OUTCOME MEASURES: 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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	W B SAUNDERS CO-ELSEVIER INC
dc.relation.ispartof	Arch Phys Med Rehabil
dc.relation.isbasedon	10.1016/j.apmr.2019.07.005
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1106 Human Movement and Sports Sciences, 1117 Public Health and Health Services
dc.subject.classification	Rehabilitation
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Continuous Positive Airway Pressure
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Patient Compliance
dc.subject.mesh	Quadriplegia
dc.subject.mesh	Severity of Illness Index
dc.subject.mesh	Sleep Apnea, Obstructive
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Humans
dc.subject.mesh	Sleep Apnea, Obstructive
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Quadriplegia
dc.subject.mesh	Continuous Positive Airway Pressure
dc.subject.mesh	Severity of Illness Index
dc.subject.mesh	Patient Compliance
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.title	Continuous Positive Airway Pressure Use for Obstructive Sleep Apnea in Acute, Traumatic Tetraplegia.
dc.type	Journal Article
utslib.citation.volume	100
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1106 Human Movement and Sports Sciences
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
utslib.copyright.status	closed_access	*
dc.date.updated	2022-09-26T03:48:42Z
pubs.issue	12
pubs.publication-status	Published
pubs.volume	100
utslib.citation.issue	12

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 OUTCOME MEASURES: 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.

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http://hdl.handle.net/10453/162068