Paola Proserpio1, Andrea Lanza1, Katrina Sambusida1, Lara Fratticci2, Pamela Frigerio3, Maurizio Sommariva4, Enrica Giuliana Stagni3, Tiziana Redaelli3, Fabrizio De Carli5, Lino Nobili6. 1. Centre of Sleep Medicine, Centre for Epilepsy Surgery "C. Munari", Niguarda Hospital, Milan, Italy. 2. Institute of Neurology, "Humanitas" Clinical Institute, Milan, Italy. 3. Spinal Cord Unit, Niguarda Hospital, Milan, Italy. 4. Emergency Department, Niguarda Hospital, Milan, Italy. 5. Institute of Bioimaging and Molecular Physiology, Genoa Unit, National Research Council, Genoa, Italy. 6. Centre of Sleep Medicine, Centre for Epilepsy Surgery "C. Munari", Niguarda Hospital, Milan, Italy; Institute of Bioimaging and Molecular Physiology, Genoa Unit, National Research Council, Genoa, Italy. Electronic address: Lino.nobili@ospedaleniguarda.it.
Abstract
BACKGROUND: Sleep disturbances are frequently reported by patients with spinal cord injury (SCI). Studies have shown an increased incidence of sleep-disordered breathing (SDB) and periodic leg movements during sleep (PLMS) in people with stable long-term SCI. METHODS: This was a prospective observational study in order to evaluate the features and possible predisposing factors of SDB and PLMS in a heterogenic population of consecutive SCI patients admitted at the Spinal Unit of the Niguarda Hospital within the first year after injury. Each patient underwent a clinical assessment, full polysomnography, and arterial blood gas analysis before and immediately after sleep. Multiple logistic regressions were applied in order to evaluate factors associated with SDB and PLMS. RESULTS: Thirty-five (15 tetraplegic and 20 paraplegic) patients were enrolled. Nine patients (25.7%) had an obstructive SDB and 10 (28.6%) had PLMS. The frequency of SDB was higher in tetraplegic with respect to paraplegic patients (Wald statistic: 7.71; P = 0.0055), whereas PLMs were significantly more frequent in patients with an incomplete motor lesion than in subjects with a complete motor lesion (Wald statistic: 6.14; P = 0.013). CONCLUSION: This study confirms a high frequency of SDB and PLMS in SCI patients in the first year following injury. Independently from possible sub-acute and chronic clinical variables, the level and the completeness of the spinal cord lesion are the main factors associated respectively with an early development of SDB and PLMS.
BACKGROUND: Sleep disturbances are frequently reported by patients with spinal cord injury (SCI). Studies have shown an increased incidence of sleep-disordered breathing (SDB) and periodic leg movements during sleep (PLMS) in people with stable long-term SCI. METHODS: This was a prospective observational study in order to evaluate the features and possible predisposing factors of SDB and PLMS in a heterogenic population of consecutive SCI patients admitted at the Spinal Unit of the Niguarda Hospital within the first year after injury. Each patient underwent a clinical assessment, full polysomnography, and arterial blood gas analysis before and immediately after sleep. Multiple logistic regressions were applied in order to evaluate factors associated with SDB and PLMS. RESULTS: Thirty-five (15 tetraplegic and 20 paraplegic) patients were enrolled. Nine patients (25.7%) had an obstructive SDB and 10 (28.6%) had PLMS. The frequency of SDB was higher in tetraplegic with respect to paraplegic patients (Wald statistic: 7.71; P = 0.0055), whereas PLMs were significantly more frequent in patients with an incomplete motor lesion than in subjects with a complete motor lesion (Wald statistic: 6.14; P = 0.013). CONCLUSION: This study confirms a high frequency of SDB and PLMS in SCI patients in the first year following injury. Independently from possible sub-acute and chronic clinical variables, the level and the completeness of the spinal cord lesion are the main factors associated respectively with an early development of SDB and PLMS.
Authors: Jordan W Squair; Amanda H X Lee; Zoe K Sarafis; Geoff Coombs; Otto Barak; Jacquelyn J Cragg; Tanja Mijacika; Renata Pecotic; Andrei V Krassioukov; Zoran Dogas; Zeljko Dujic; Aaron A Phillips Journal: Neurology Date: 2019-11-06 Impact factor: 9.910
Authors: Stephanie K Rigot; Michael L Boninger; Dan Ding; Gina McKernan; Edelle C Field-Fote; Jeanne Hoffman; Rachel Hibbs; Lynn A Worobey Journal: Arch Phys Med Rehabil Date: 2021-04-08 Impact factor: 3.966
Authors: David J Berlowitz; Rachel Schembri; Marnie Graco; Jacqueline M Ross; Najib Ayas; Ian Gordon; Bonne Lee; Allison Graham; Susan V Cross; Martin McClelland; Paul Kennedy; Pradeep Thumbikat; Cynthia Bennett; Andrea Townson; Timothy J Geraghty; Sue Pieri-Davies; Raj Singhal; Karen Marshall; Deborah Short; Andrew Nunn; Duncan Mortimer; Doug Brown; Robert J Pierce; Peter A Cistulli Journal: Thorax Date: 2018-12-11 Impact factor: 9.139