Estimated prevalence of obstructive sleep apnea-hypopnea syndrome after cervical cord injury.

Abstract

To estimate the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients with cervical cord injury and to identify predictive factors. Cross-sectional study. Rehabilitation center. Forty-one adults with cervical cord injury of more than 6 months in duration. Medical history, physical exam, and full in home overnight polysomnography were undertaken. Data were collected on characteristics of spinal cord injury, current medication, sleeping habits, daytime sleepiness, body mass index (BMI), and neck circumference. Presence or absence of OSAHS as defined by the American Academy of Sleep Medicine criteria (1999). Twenty-two (53%) patients (95% confidence interval [CI], 38.4%-68.9%) had OSAHS. Daytime sleepiness (odds ratio [OR], 41.1; 95% CI, 2.3-739.7; P=.02), BMI of 30 kg/m2 or higher (OR=17.2; 95% CI, 1.4-206.4; P=.03), and 3 or more awakenings during sleep (OR=34; 95% CI, 1.6-744.8; P=.03) were the best predictive factors of OSAHS obtained by a forward stepwise multiple logistic regression. The estimated prevalence of OSAHS is high after cervical cord injury. OSAHS should be suspected, especially in patients with daytime sleepiness, obesity, and frequent awakenings during sleep.