Chiodo Anthony E, Sitrin Robert G, Bauman Kristy A
a SCI Program, Department of Physical Medicine and Rehabilitation , University of Michigan Medical Center , Ann Arbor , MI , USA.
b Pulmonary and Critical Care Medicine Division, Department of Internal Medicine , University of Michigan Health System , Ann Arbor , MI , USA.
J Spinal Cord Med. 2016 Jul;39(4):374-82. doi: 10.1080/10790268.2015.1126449. Epub 2016 Mar 15.
Spinal cord injury commonly results in neuromuscular weakness that impacts respiratory function. This would be expected to be associated with an increased likelihood of sleep-disordered breathing.
(1) Understand the incidence and prevalence of sleep disordered breathing in spinal cord injury. (2) Understand the relationship between injury and patient characteristics and the incidence of sleep disordered breathing in spinal cord injury. (3) Distinguish between obstructive sleep apnea and central sleep apnea incidence in spinal cord injury. (4) Clarify the relationship between sleep disordered breathing and stroke, myocardial infarction, metabolic dysfunction, injuries, autonomic dysreflexia and spasticity incidence in persons with spinal cord injury. (5) Understand treatment tolerance and outcome in persons with spinal cord injury and sleep disordered breathing.
Extensive database search including PubMed, Cochrane Library, CINAHL and Web of Science.
Given the current literature limitations, sleep disordered breathing as currently defined is high in patients with spinal cord injury, approaching 60% in motor complete persons with tetraplegia. Central apnea is more common in patients with tetraplegia than in patients with paraplegia.
Early formal sleep study in patients with acute complete tetraplegia is recommended. In patients with incomplete tetraplegia and with paraplegia, the incidence of sleep-disordered breathing is significantly higher than the general population. With the lack of correlation between symptoms and SDB, formal study would be reasonable. There is insufficient evidence in the literature on the impact of treatment on morbidity, mortality and quality of life outcomes.
脊髓损伤通常会导致神经肌肉无力，进而影响呼吸功能。预计这会增加睡眠呼吸障碍的可能性。
（1）了解脊髓损伤患者睡眠呼吸障碍的发病率和患病率。（2）了解损伤与患者特征之间的关系以及脊髓损伤患者睡眠呼吸障碍的发病率。（3）区分脊髓损伤患者中阻塞性睡眠呼吸暂停和中枢性睡眠呼吸暂停的发病率。（4）阐明脊髓损伤患者睡眠呼吸障碍与中风、心肌梗死、代谢功能障碍、损伤、自主神经反射亢进和痉挛发病率之间的关系。（5）了解脊髓损伤合并睡眠呼吸障碍患者的治疗耐受性和治疗效果。
广泛检索数据库，包括PubMed、Cochrane图书馆、CINAHL和科学网。
鉴于目前文献的局限性，按照目前的定义，脊髓损伤患者的睡眠呼吸障碍发生率较高，四肢瘫运动完全性损伤患者接近60%。中枢性呼吸暂停在四肢瘫患者中比截瘫患者更常见。
建议对急性完全性四肢瘫患者尽早进行正式的睡眠研究。在不完全性四肢瘫和截瘫患者中，睡眠呼吸障碍的发生率明显高于一般人群。由于症状与睡眠呼吸障碍之间缺乏相关性，进行正式研究是合理的。关于治疗对发病率、死亡率和生活质量结局的影响，文献中证据不足。
