Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/21633
Title: Continuous Positive Airway Pressure use for Obstructive Sleep Apnea in Acute, Traumatic Tetraplegia.
Authors: Graco, Marnie;Schembri, Rachel M;Ross, Jacqueline M;Green, Sally E;Booker, Lauren A;Cistulli, Peter A;Ayas, Najib T;Berlowitz, David J;Lee, Bonne;Graham, Allison;Cross, Susan V;McClelland, Martin;Thumbikat, Pradeep;Bennett, Cynthia;Townson, Andrea;Geraghty, Timothy J;Pieri-Davies, Sue;Singhal, Raj;Marshall, Karen;Short, Deborah;Nunn, Andrew K;Brown, Doug
Affiliation: Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
Prince of Wales Hospital, Barker Street, Randwick, NSW 2031. Australia
University of British Columbia, Department of Physical Medicine & Rehabilitation, GF Strong Rehab Centre, 4255 Laurel Street, Vancouver BC V5Z 2G9 Canada
Spinal Research Institute, Austin Health, Heidelberg, Victoria, Australia
Victorian Spinal Cord Service, Austin Health, Heidelberg, Victoria, Australia
Neuroscience Research Australian (NeuRA), Barker Street, Randwick, NSW 2031. Australia
The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences. Melbourne, Vic 3010, Australia
Department of Respiratory and Sleep Medicine. Royal North Shore, St. Leonard's, NSW, 2065; Charles Perkins Centre and Faculty of Medicine and Health, University of Sydney, NSW. 2006. Australia
Burwood Spinal Unit, Burwood Hospital, Canterbury District Health Board. Private Bag 4708, Christchurch, 8140, New Zealand
Queensland Spinal Cord Injuries Service and The Hopkins Centre, Research for Rehabilitation and Resilience. Metro South Health and Griffith University. Ipswich Road, Woolloongabba, Queensland, 4102. Australia
Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
University of British Columbia, Faculty of Medicine. 2775 Laurel Street, Vancouver, BC Canada V5Z 1M9
National Spinal Injuries Centre. Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, HP21 8AL, United Kingdom
Princess Royal Spinal Cord Injuries Centre, Northern General Hospital. Herries Road, Sheffield S5 7AU, United Kingdom
Auckland Spinal Rehabilitation. Private Bag 93319, Otahuhu, Auckland 1640
North West Regional Spinal Injuries Centre, Southport Hospital. Town Lane. Southport PR8 6PN, United Kingdom
Midland Centre for Spinal Injuries, The Robert Jones & Agnes Hunt Orthopaedic Hospital. Oswestry Shropshire SY10 7AG United Kingdom
Issue Date: 14-Aug-2019
EDate: 2019-08-14
Citation: Archives of physical medicine and rehabilitation 2019; online first: 14 August
Abstract: To describe continuous positive airway pressure (CPAP) use for treatment of obstructive sleep apnea (OSA) in acute tetraplegia, including adherence rates and associated factors. Secondary analysis of CPAP data from a multinational randomized controlled trial. Inpatient rehabilitation units of 11 spinal cord injury centres. People with acute, traumatic tetraplegia and OSA. Auto-titrating CPAP for OSA for three months. Adherence measured as mean daily hours of use. Adherent (yes/no) was defined as an average of at least four hours a night throughout the study. Regression analyses determined associations between baseline factors and adherence. CPAP device pressure and leak data were analysed descriptively. 79 participants from 10 spinal units (91% male, mean age 46 (SD=16), 78 (SD=64) days post-injury) completed the study in the treatment arm and 33% were adherent. Mean daily CPAP use was 2.9 hours (SD=2.3). Better adherence was associated with more severe OSA (p=0.04), and greater CPAP use in the first week (p<0.01). Average 95th percentile pressure was low (9.3cmH2O; SD=1.7) and 95th percentile leak was high (27.1L/min; SD=13.4). Adherence to CPAP following acute, traumatic tetraplegia is low. Early acceptance of therapy and more severe OSA predict CPAP use over three months. People with acute tetraplegia require less pressure to treat their OSA than the non-disabled; however, air leak is high. These findings highlight the need for further investigation of OSA treatment in acute tetraplegia.
URI: http://ahro.austin.org.au/austinjspui/handle/1/21633
DOI: 10.1016/j.apmr.2019.07.005
ORCID: 0000-0003-3087-887X
0000-0002-2562-1829
0000-0002-0533-3715
0000-0003-2543-8722
PubMed URL: 31421094
Type: Journal Article
Subjects: Continuous positive airway pressure
Spinal cord injuries
patient compliance
sleep apnea syndromes
Appears in Collections:Journal articles

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