Sleep-Disordered Breathing and Spinal Cord Injury: Challenges and Opportunities

被引：9
|
作者：
Sankari A. [1 ,2 ]
Martin J.L. [3 ,4 ]
Safwan Badr M. [1 ,2 ]
机构：
[1] John D. Dingell VA Medical Center, Detroit, MI
[2] Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University, 3990 John R, 3-Hudson, Detroit, 48201, MI
[3] VA Greater Los Angeles Healthcare System, North Hills, Los Angeles, CA
[4] David Geffen School of Medicine at the University of California, Los Angeles, CA
来源：
Current Sleep Medicine Reports | 2017年 / 3卷 / 4期
关键词：
Periodic leg movements; Sleep disturbances; Sleep-disordered breathing; Spinal cord injury; Tetraplegia;
D O I：
10.1007/s40675-017-0093-0
中图分类号：
学科分类号：
摘要：
Purpose of Review: This paper focuses on the sleep disorders in patients with spinal cord injury/disorder (SCI/D), particularly mechanism of sleep-disordered breathing (SDB) and challenges in diagnosis and management. Based on a review of recent literatures and studies, the paper summarizes some main challenges with respect to management of SDB in patients with SCI; what are the responsible mechanisms of disease? What are the barriers in diagnosing and treating SDB using standard treatment such as continuous positive airway pressure (CPAP)? Recent Findings: Previous studies have shown that most SCI/D patients have SDB with heterogeneity in prevalence mainly related to using different definitions or methods of diagnosing SDB, while recent studies using new definition of SDB based on recommended criteria from the American Academy of Sleep Medicine (AASM) and also include the data on effect of SCI/D level on prevalence and describe different types of SDB. Furthermore, recent data describes simplified method of diagnosing SDB by using a combination of home sleep apnea testing and transcutaneous CO2 monitoring. Finally, emerging data has been pointing at strong relationship between SDB and cardiovascular disease including nocturnal hypertension in patients with SCI/D. Summary: The findings indicate that early testing for SDB and associated cardiovascular disease in patients with SCI is recommended and could be beneficial in reducing the high morbidity and mortality in this group of patients with disability. In addition, studies on treatment of other sleep disorders in SCI/D are not available to inform clinical decision-making. Understanding the pathophysiology of sleep disorders in SCI/D is critical for the development of new effective therapies. This review provides evidence for best practices, highlights new discoveries for the diagnosis and management of sleep disorders in SCI/D, and discusses challenges and future directions. © 2017, US Government (outside the USA).
引用
收藏
页码：272 / 278
页数：6
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