Neurology Medical News about obstructive sleep apnea;acute tetraplegia;auto-titrating continuous positive airway pressure

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The feasibility of using auto-titrating continuous positive airway pressure to treat obstructive sleep apnoea after acute tetraplegia
Spinal Cord, 06/04/09

Berlowitz DJ et al. – Auto-titrating continuous positive airway pressure (CPAP) is a feasible treatment for obstructive sleep apnoea (OSA) in acute tetraplegia. Initial intensive clinical support is required, and tolerance of therapy for at least 4 hr for 1 of the first 3 days predicts good CPAP usage.

Methods

Prospective cohort study of the feasibility of auto-titrating CPAP to treat OSA after acute tetraplegia
Full, portable polysomnography for all pts
Pts with apnoea hypopnoea index of >10 events/hr defined as having OSA and offered CPAP treatment
Objective monitoring of treatment adherence
Measures of quality of life, sleepiness and functional outcomes determined at enrollment and 3 mo later at study conclusion

Results

Of 44 pts admitted to Spinal Cord Service over 9 mo, 19 participated
OSA for 14 pts; 7 pts adherent with therapy for 3 mo
Compared with non-OSA pts and OSA pts not adherent with CPAP, OSA-CPAP pts were older and had a higher body mass index
CPAP-adherant pts and with non-OSA pts showed ≥50% improvement in sleepiness state over 3 mo
OSA pts who did not tolerate CPAP had no improvement in sleepiness

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