title: A longitudinal evaluation of sleep and breathing in the first year after cervical spinal cord injury.
abstract: OBJECTIVE
  To establish the incidence of sleep disordered breathing (SDB) after acute tetraplegia and to determine the relation between the Apnea-Hypopnea Index (AHI) score and the previously postulated predictors of SDB in tetraplegia.
  
  
  METHODS
  Inception cohort. We performed full polysomnography immediately after acute tetraplegia and at 2, 4, 13, 26, and 52 weeks postinjury. Spirometry, maximum inspiratory and expiratory pressures, medication usage, and neck and abdominal girth were also assessed. Preinjury SDB was estimated using the multivariate apnea prediction equation.
  
  
  METHODS
  Acute care, subacute care, and community.
  
  
  METHODS
  Consecutive sample with acute tetraplegia. Thirty subjects (25 men) were initially included. Thirteen completed 12 months of follow-up.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  SDB (AHI score >10 events/h) and respiratory function.
  
  
  RESULTS
  Three subjects (10%; 95% confidence interval [CI], 2%-28%) had probable SDB before injury. In the first 48 hours after injury, no subject had SDB. At 2 weeks, 60% (95% CI, 26%-88%) had SDB; at 4 weeks, 62% (95% CI, 38%-82%); at 13 weeks, 83% (95% CI, 61%-95%); at 26 weeks, 68% (95% CI, 44%-88%); and at 52 weeks, 62% (95% CI, 32%-86%). No consistent relation was found between the previously postulated predictors and SDB.
  
  
  CONCLUSIONS
  SDB is highly prevalent within 4 weeks of acute tetraplegia.
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Studley Road, Heidelberg, Victoria 3084, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Berlowitz
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Brown
authors.forename: Donald A
authors.initials: DA
authors.lastname: Campbell
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Pierce
mesh_terms: D000005:Abdomen / Q000254:growth & development; D000293:Adolescent; D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001418:Baclofen / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009333:Neck / Q000254:growth & development; D017286:Polysomnography; D011446:Prospective Studies; D011782:Quadriplegia / Q000150:complications* / Q000188:drug therapy; D012129:Respiratory Function Tests; D012891:Sleep Apnea Syndromes / Q000209:etiology*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000188:drug therapy; D013997:Time Factors
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D009125:Muscle Relaxants, Central; D001418:Baclofen