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  4. Positive airway pressure for sleep-disordered breathing in acute quadriplegia: a randomised controlled trial

Positive airway pressure for sleep-disordered breathing in acute quadriplegia: a randomised controlled trial

Thorax, 2019 · DOI: 10.1136/thoraxjnl-2018-212319 · Published: February 1, 2019

Spinal Cord InjuryPulmonologyRehabilitation

Simple Explanation

This study investigated whether CPAP therapy could improve neurocognitive function and sleepiness in people with acute quadriplegia who have sleep-disordered breathing. The researchers found that while CPAP did not improve cognitive function, it did significantly reduce sleepiness in this population. The findings suggest that managing sleepiness in quadriplegia is important, even if CPAP doesn't fully address cognitive impairments.

Study Duration
July 2009 to October 2015
Participants
149 participants (134 men) with acute quadriplegia
Evidence Level
Level 1, Multinational, randomised controlled trial

Key Findings

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    CPAP treatment did not significantly improve scores on the Paced Auditory Serial Addition Task (PASAT), a measure of attention and information processing.
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    CPAP treatment significantly reduced sleepiness, as measured by the Karolinska Sleepiness Scale (KSS).
  • 3
    The study confirmed that sleep-disordered breathing is highly prevalent in individuals with acute quadriplegia.

Research Summary

This multinational, randomised controlled trial examined the effectiveness of CPAP therapy for treating sleep-disordered breathing in individuals with acute quadriplegia. The study found that CPAP did not significantly improve neurocognitive function but did significantly reduce sleepiness. The researchers suggest that managing sleepiness is a worthwhile goal in this population and that further research into alternative therapies for those intolerant of CPAP is warranted.

Practical Implications

Clinical Practice

Treating sleepiness from SDB is important in quadriplegia.

Future Research

Exploration of novel therapies for those who are intolerant of CPAP deserves further investigation.

Understanding SDB

Emerging evidence suggests that SDB in quadriplegia may result from different combinations of phenotypic factors than in the non-disabled population

Study Limitations

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