Neuropsychological function in patients with acute tetraplegia and sleep disordered breathing

Abstract

STUDY OBJECTIVES: To investigate the relationship between apnoea severity and neuropsychological function in patients with acute onset tetraplegia and sleep disordered breathing. METHODS: Polysomnography and neuropsychological testing were performed on 104 participants (age M=45.60, SD=16.38; 10 female) across 11 international sites, two months post-injury (M=60.70 days, SD=39.48). Neuropsychological tests assessed attention, information processing, executive function, memory, learning, mood, and quality of life. RESULTS: More severe sleep apnoea was associated with poorer attention, information processing, and immediate recall. Deficits did not extend to memory. Higher pre-injury intelligence and being younger reduced the associations with sleep disordered breathing, however, these protective factors were insufficient to counter the damage to attention, immediate recall, and information processing associated with sleep disordered breathing. CONCLUSIONS: These data suggest that new spinal cord injury may function as a model of "acute sleep apnoea", and that more widespread sleep apnoea-related deficits, including memory, may only be seen with longer exposure to apnoea. These findings have important implications for functioning and skill acquisition during rehabilitation and, as such, highlight the importance of sleep health following tetraplegia.