A new study suggests that patients with spinal cord injuries could benefit from careful assessment for sleep apnea.
Results show that 77 percent of spinal cord injury survivors had symptomatic sleep-disordered breathing, and 92 percent had poor sleep quality. The study also found that the nature of sleep-disordered breathing in patients with spinal cord injury is complex, with a high occurrence of both obstructive and central sleep apnea events. The occurrence of central sleep apnea, which requires special consideration in diagnosis and treatment, was more common in patients with a cervical injury than in those with a thoracic injury.
“The majority of spinal cord injury survivors have symptomatic sleep-disordered breathing and poor sleep that may be missed if not carefully assessed,” said principal investigator and lead author Dr. Abdulghani Sankari, physician scientist at John D. Dingell VA Medical Center and Wayne State University School of Medicine in Detroit, Mich. “Our findings help in identifying the mechanism of sleep-disordered breathing in spinal cord injury and may provide potential targets for new treatment.”
The study results appear in the Jan. 15 issue of the Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine.
“Sleep-disordered breathing may contribute to increased cardiovascular mortality in spinal cord injury patients,” said American Academy of Sleep Medicine President Dr. M. Safwan Badr, who was involved in the study. “All spinal cord injury patients should undergo a comprehensive sleep evaluation using full, overnight polysomnography for the accurate diagnosis of sleep apnea.”
Sankari and his team studied 26 chronic spinal cord injury patients, including 15 with cervical and 11 with thoracic injuries. All subjects had baseline spirometry, a battery of questionnaires and attended polysomnography with flow and pharyngeal pressure measurements.
According to the authors, this is the first study to assess sleep-disordered breathing and ventilation changes comparing two different levels of spinal cord injury — cervical vs. thoracic.
Hello, i have had Sleep Apnea since my injury in 2008. I had surgery on my Cervical section, from C3 -C7 and also T1. I had a fusion between C5 and C6. I only sleep a few hours a night, if even that. I sleep for 3 hours and i wake up and feel like i have slept 8 hours. And i’m always depressed with all the pain i have every day. I am on several medications, including Oxycodone, Methadone,Cymbalta Etc. for chronic pain. I go to Pain Management every 3 months to get refills on my prescriptions. I’m crying every day because of my pain, and i am on the maximum amount of medication that i could take at this time. I don’t know what else to do at this point. I have no more resources that i could do at this point and time. If anyone has any suggestions for me, i would very much appreciate you letting me know. Thank you, Jack.
Thank you for this report. I have been trying to convince her ( Marci, my wife), and her Doctors, that she has this problem. Now I have some ammunition to back me up. I try to do the best by and for Marci, but some times its hard to get by the resentments when one person tells another they may ,have a problem. Again, thank you.
Paul R. Thompson
This is in response to Jack Crapisi….my heart goes out to you and all the meds you are on. I have had chronic back pain and been on high dose narcotics…the same ones you mentioned that you are on plus many more including Fentanyl patches and Exalgo for 15-20 years. I was so desperate for pain relief that I had a pain pump implanted after going through a successful trial and less than one year after having it put in, a granuloma grew at the tip of the catheter, causing a spinal cord injury and I lost the use of my right leg. I have been in a wheelchair ever since (11 1/2 years) and have a leg brace that allows me to walk a little with a walker and ride a stationary bike. I had to have a lumbar fusion about 4 years ago to keep my scoliosis from getting worse and my neurosurgeon wanted me off of ALL of my pain meds before he would do the surgery. Well, I got off of everything except for the oxycodone and had the fusion. My back pain persisted and I have been going to a pain clinic for many, many years and was back on super-high doses of narcotics once again. Finally, I decided that I had had enough and was determined to see how I would feel without all these drugs in my system. Well, getting off the MS Contin, Exalgo, Cymbalta, Oxycontin, etc was fairly easy, but getting off of the oxycodone was horrible… I gradually reduced my dosage, but then just went cold turkey…it was the worse 2 weeks of my life, but now that I am narcotic-free, I feel better than I have felt in years. My back feels better than it ever did on the pain meds. I know it sounds weird, but I had several Dr’s suggest that the pain pills might be making my pain worse and of course, I thought they were nuts. I don’t know if this is something that you want to try, but it sounds to me like you couldn’t feel any worse than you feel now and you just might feel better. I am able to walk much more with my walker and leg brace since I don’t have the excruciating back pain. I also have a deep faith in God and believe that He can do miracles. And I am praying for one for you! May God bless you! – Kim