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  4. Screening for treatment‑required sleep apnoea in patients with spinal cord injury within one year after injury in a rehabilitation setting

Screening for treatment‑required sleep apnoea in patients with spinal cord injury within one year after injury in a rehabilitation setting

Sleep and Breathing, 2024 · DOI: https://doi.org/10.1007/s11325-024-03062-9 · Published: May 15, 2024

Spinal Cord InjuryPulmonologyRehabilitation

Simple Explanation

Sleep apnea is more common in individuals with spinal cord injuries (SCI) than in the general population, but it's often underdiagnosed. Therefore, regular screening is necessary. This study checks how well a questionnaire (SBQ) works to find people with SCI who need treatment for sleep apnea and whether combining it with a simple pulse oximetry test improves accuracy. The study found that SBQ alone is not accurate enough, but when combined with pulse oximetry, it can better identify those who need treatment while reducing unnecessary further tests.

Study Duration
5 Months
Participants
24 SCI patients
Evidence Level
Cross-sectional observational study

Key Findings

  • 1
    The SBQ alone is insufficient for screening treatment-required sleep apnoea in SCI patients.
  • 2
    Combining SBQ with pulse oximetry enhances accuracy in identifying patients with sleep apnoea.
  • 3
    There was a 75% prevalence of mild to severe sleep apnoea among the 24 included patients.

Research Summary

This study evaluated the effectiveness of the Stop-Bang Questionnaire (SBQ) in screening for treatment-required sleep apnoea (TRSA) in patients with spinal cord injury (SCI) within one year of injury in a rehabilitation setting. The study found that while SBQ is sensitive in detecting TRSA, it lacks specificity, leading to many false positives. Combining SBQ with pulse oximetry improved both sensitivity and specificity. The research suggests that SBQ combined with pulse oximetry might be a more accurate method for screening TRSA in a mixed tetra-/paraplegic population of SCI, warranting further validation in a larger sample size.

Practical Implications

Improved Screening Accuracy

Combining SBQ with pulse oximetry can improve the accuracy of sleep apnea screening in SCI patients.

Reduced Unnecessary Referrals

Using SBQ with pulse oximetry can reduce the number of unnecessary referrals for cardiorespiratory monitoring (CRM).

Cost-Effective Screening

The combined approach may offer a more cost-effective way to identify SCI patients at risk of sleep apnea.

Study Limitations

  • 1
    Small sample size
  • 2
    Potential reporting bias in patient-reported outcomes (snoring, apnoea)
  • 3
    Clinical decision of TRSA might introduce bias

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