Please use this identifier to cite or link to this item:
Title: Worth the effort? Weighing up the benefit and burden of continuous positive airway pressure therapy for the treatment of obstructive sleep apnoea in chronic tetraplegia.
Austin Authors: Graco, Marnie ;Green, Sally E;Tolson, Julie ;Stevens, Bronwyn ;Barnes, Maree ;Rigoni, Alyssa;Henderson, Sandra;Nicholls, Carmel ;Berlowitz, David J 
Affiliation: Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
The University of Melbourne, Department of Medicine, Melbourne, Victoria, Australia
The University of Melbourne, Department of Physiotherapy, Melbourne, Victoria, Australia
Issue Date: 24-Oct-2018 2018-10-24
Publication information: Spinal Cord 2018; online first: 24 October
Abstract: Mixed methods OBJECTIVES: Continuous positive airway pressure (CPAP) therapy is the recommended treatment for obstructive sleep apnoea (OSA). The aim of this study was to estimate CPAP adherence in people with tetraplegia and OSA, and to explore the barriers and facilitators to CPAP use. Hospital outpatient department in Melbourne, Australia METHODS: People with chronic tetraplegia and OSA were commenced with auto-titrating CPAP and supported for 1 month. Semi-structured interviews were conducted with participants at one month and analysed thematically. CPAP usage was measured at 1, 6 and 12 months, with "adherent" defined as achieving more than 4 h average per night. Sixteen participants completed the study (80% male; mean age 56 (SD = 15)). Mean nightly CPAP use at one month was 3.1 h (SD = 2.5; 38% adherent), and at 6 months and 12 months were 2.6 h (SD = 2.8; 25% adherent) and 2.1 h (SD = 3.2; 25% adherent). The perceived benefit/burden balance strongly influenced ongoing use. Burden attributed to CPAP use was common, and included mask discomfort, and physical and emotional problems. Adherent participants were motivated by the immediate daytime benefits to mood, alertness and sleepiness. There was a tendency to not recognise symptoms of OSA until after they were treated. CPAP use is challenging for people with tetraplegia, who experience substantial burden from using the device. When tolerated, the proximate benefits are substantial. People with tetraplegia need more intensive support for longer to help them overcome the burdens of CPAP and benefit from the treatment.
DOI: 10.1038/s41393-018-0210-z
ORCID: 0000-0001-6048-0147
PubMed URL: 30356181
Type: Journal Article
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Dec 4, 2022

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.