Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia.
Spinal Cord. 2009 Dec;47(12):868-73. doi: 10.1038/sc.2009.56. Epub 2009 Jun 2.
A prospective cohort with acute tetraplegia.
Obstructive sleep apnoea (OSA) is common within weeks of tetraplegia. This study aimed at determining the feasibility of auto-titrating continuous positive airway pressure (CPAP) to treat OSA after acute tetraplegia.
The Victorian Spinal Cord Service, Melbourne, Australia.
Participants underwent full, portable polysomnography. Those with an apnoea hypopnoea index of more than 10 events per hour were defined as having OSA and were offered treatment with CPAP. Treatment adherence was objectively monitored, and measures of quality of life, sleepiness and functional outcomes were determined at enrollment and 3 months later at study conclusion.
A total of 44 patients were admitted to our Spinal Cord Service over 9 months, and 19 participated. Fourteen of them had OSA and seven were adherent with therapy for 3 months. Compared with those who did not have OSA, and with those with OSA who were not adherent with CPAP, those who adhered to CPAP were older (mean (s.d.) age 54 years (13) versus non-adherent 28 years (15) and no OSA 29 years (10)) and heavier (body mass index (BMI) 32.5 (11.7), 24.1 (3.7) and 20.6 (3.1), respectively). CPAP-adherant patients and those without OSA showed a 50% or greater improvement in their state sleepiness over the 3 months. Patients with OSA who did not tolerate CPAP had no improvement in sleepiness.
Auto-titrating CPAP is a feasible treatment for OSA in acute tetraplegia. Intensive clinical support was required initially, and a tolerance of therapy for at least 4 h for one of the first 3 days was predictive of good CPAP usage.
Transport Accident Commission.
急性四肢瘫痪的前瞻性队列研究。
四肢瘫痪后数周内阻塞性睡眠呼吸暂停（OSA）很常见。本研究旨在确定自动滴定持续气道正压通气（CPAP）治疗急性四肢瘫痪后 OSA 的可行性。
澳大利亚墨尔本维多利亚脊髓服务中心。
参与者接受全面的便携式多导睡眠图检查。每小时呼吸暂停低通气指数超过 10 次的患者被定义为患有 OSA，并提供 CPAP 治疗。通过客观监测治疗依从性，并在研究结束时（3 个月后）确定生活质量、嗜睡和功能结果的测量值。
在 9 个月内，共有 44 名患者入住我们的脊髓服务中心，其中 19 名患者参与了研究。其中 14 名患者患有 OSA，7 名患者在 3 个月内坚持治疗。与未患 OSA 的患者和未坚持 CPAP 治疗的 OSA 患者相比，坚持 CPAP 治疗的患者年龄更大（平均（标准差）年龄 54 岁（13），而非 OSA 为 28 岁（15））和更重（体重指数（BMI）分别为 32.5（11.7）、24.1（3.7）和 20.6（3.1））。CPAP 依从性患者和无 OSA 患者在 3 个月内的嗜睡状态改善了 50%或更多。不能耐受 CPAP 的 OSA 患者嗜睡状况无改善。
自动滴定 CPAP 是急性四肢瘫痪中 OSA 的一种可行治疗方法。最初需要强化临床支持，并且在最初 3 天中的至少 1 天中耐受治疗 4 小时以上是良好 CPAP 使用的预测因素。
运输事故委员会。
