title: [Case of obstructive sleep apnea syndrome exacerbated due to cervical spinal cord injury].
abstract: A 70-year-old man injured his spinal cord at the fourth cervical vertebra due to a fall and became quadriplegic. Following emergency treatment, the patient was admitted to our hospital for rehabilitation. On admission, respiratory function tests indicated a percent vital capacity value (%VC) of 58.6%, revealing restrictive ventilatory impairment. After admission, we observed difficulty breathing at night and extreme snoring and thus performed a simple full-night polysomnography. Results showed an apnea-hypopnea index (AHI) of 46.5/hr and serious obstructive sleep apnea syndrome (OSAS). Based on these results, we conjectured that a preexisting OSAS condition was exacerbated by the cervical spinal cord injury, and thus administered nasal continuous positive airway pressure (NCPAP) in addition to respiratory rehabilitation. A speedy disappearance of clinical symptoms was found with the application of NCPAP. Compared to a 3% oxygen desaturation index (ODI 3%) of 31.0 dips/hr prior to treatment, the ODI 3% dropped to 3.5 dips/hr after 14 days, and 0 dips/hr after 60 days, indicating an obvious improvement in nocturnal oxygen desaturation.
authors.affiliation: Department of Internal Medicine, Beppu-Rehabilitation-Center.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagaoka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Kishi
authors.forename: Issei
authors.initials: I
authors.lastname: Tokimatsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nagai
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kadota
mesh_terms: D000368:Aged; D045422:Continuous Positive Airway Pressure; D006801:Humans; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy; D013119:Spinal Cord Injuries / Q000150:complications*