Marnie Graco1,2,3,4, Luke McDonald5, Sally E Green6, Melinda L Jackson7,8, David J Berlowitz7,9,5. 1. Department of Allied Health, Alfred Health, Melbourne, VIC, Australia. ma.graco@alfred.org.au. 2. Department of Allied Health, La Trobe University, Melbourne, VIC, Australia. ma.graco@alfred.org.au. 3. Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia. ma.graco@alfred.org.au. 4. Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia. ma.graco@alfred.org.au. 5. Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia. 6. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 7. Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia. 8. Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia. 9. Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.
Abstract
STUDY DESIGN: Systematic review with meta-analysis. OBJECTIVES: To determine the prevalence of sleep-disordered breathing (SDB) in people with tetraplegia and to identify the characteristics associated with SDB. METHODS: A systematic literature search using Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and grey literature sources was conducted using a combination of spinal cord injury (SCI) and SDB related terms. Articles were restricted to publication dates between 1/1/2000 and 4/9/2020 and with objectively measured SDB with an overnight sleep study. The frequency of SDB stratified by the apnoea hypopnea index (AHI) was extracted and weighted averages, using a random effects model, were calculated with 95% confidence intervals. Sub-group analyses were performed where possible. RESULTS: Twelve articles were included in the review; of these nine were included in meta-analysis (combined sample = 630). Sample sizes and case detection methods varied. Reported SDB prevalence rates ranged from 46 to 97%. The prevalence of at least mild (AHI ≥ 5), moderate (AHI ≥ 15) and severe (AHI ≥ 30) SDB were 83% (95% CI = 73-91), 59% (46-71) and 36% (26-46), respectively. Sub-group analyses found that prevalence increased with age (p < 0.001). There were no statistically significant differences in SDB prevalence by sex (p = 0.06), complete/incomplete SCI (p = 0.06), body mass index (p = 0.07), acute/chronic SCI (p = 0.73) or high/low level of cervical SCI (p = 0.90). CONCLUSION: Our results confirm that SDB is highly prevalent in people with tetraplegia, and prevalence increases with age. The high prevalence suggests that routine screening and subsequent treatment should be considered in both acute and community care.
STUDY DESIGN: Systematic review with meta-analysis. OBJECTIVES: To determine the prevalence of sleep-disordered breathing (SDB) in people with tetraplegia and to identify the characteristics associated with SDB. METHODS: A systematic literature search using Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and grey literature sources was conducted using a combination of spinal cord injury (SCI) and SDB related terms. Articles were restricted to publication dates between 1/1/2000 and 4/9/2020 and with objectively measured SDB with an overnight sleep study. The frequency of SDB stratified by the apnoea hypopnea index (AHI) was extracted and weighted averages, using a random effects model, were calculated with 95% confidence intervals. Sub-group analyses were performed where possible. RESULTS: Twelve articles were included in the review; of these nine were included in meta-analysis (combined sample = 630). Sample sizes and case detection methods varied. Reported SDB prevalence rates ranged from 46 to 97%. The prevalence of at least mild (AHI ≥ 5), moderate (AHI ≥ 15) and severe (AHI ≥ 30) SDB were 83% (95% CI = 73-91), 59% (46-71) and 36% (26-46), respectively. Sub-group analyses found that prevalence increased with age (p < 0.001). There were no statistically significant differences in SDB prevalence by sex (p = 0.06), complete/incomplete SCI (p = 0.06), body mass index (p = 0.07), acute/chronic SCI (p = 0.73) or high/low level of cervical SCI (p = 0.90). CONCLUSION: Our results confirm that SDB is highly prevalent in people with tetraplegia, and prevalence increases with age. The high prevalence suggests that routine screening and subsequent treatment should be considered in both acute and community care.
Authors: D Sajkov; R Marshall; P Walker; I Mykytyn; R D McEvoy; J Wale; H Flavell; A T Thornton; R Antic Journal: Spinal Cord Date: 1998-04 Impact factor: 2.772
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