Article

OBJECTIVE: To examine the relationships between injury severity, quality of life,
sleep symptoms, objectively measured sleep, and sleep disorders in chronic
tetraplegia. DESIGN: Cross-sectional survey. SETTING: Community. PARTICIPANTS:
People with tetraplegia (N=78; 59 men, 35 with motor and sensory complete
tetraplegia; mean age +/- SD, 43+/-12.1; age range 18-70y), living in the state
of Victoria, Australia, who were not currently being treated for sleep disorders
and who completed both questionnaires and sleep studies comprised the study
cohort. INTERVENTION: Questionnaire battery mailed to potential participants.
Returned questionnaires were followed with full, home-based polysomnography. MAIN
OUTCOME MEASURES: Demographics and questionnaire responses. RESULTS: Quality of
life (Assessment of Quality of Life instrument) was worse in the group with
complete lesions compared with incomplete lesions (P=.001; median=16;
interquartile range, 9 vs 12 [12]), and the Apnea-Hypopnea Index was higher
(P=.002; interquartile range, 32.0 [25.2] vs 13.2 [24.8]). Ninety-one percent of
those with complete lesions had obstructive sleep apnea (Apnea-Hypopnea Index
>10) versus 55.8% of those with incomplete tetraplegia. No effect of lesion level
on the Apnea-Hypopnea Index was observed (r=-.04, P=.73). In the complete group,
the time taken from sleep onset until the first rapid eye movement sleep period
was significantly delayed at over 2 hours. Multiple regression analyses showed
substantially stronger relationships between daytime sleep complaints and
abnormalities observed in the sleep study in those with complete lesions.
CONCLUSIONS: Obstructive sleep apnea is a major problem, particularly in those
with complete tetraplegia, and this single comorbidity is associated with reduced
quality of life. In those with incomplete cervical lesions, the relationships
between sleepiness, other sleep symptoms, and polysomnography indices are less
precise.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS