title: Concurrent respiratory resistance training and changes in respiratory muscle strength and sleep in an individual with spinal cord injury: case report.
abstract: BACKGROUND
  Quality sleep possesses numerous benefits to normal nighttime and daytime functioning. High-level spinal cord injury (SCI) often impacts the respiratory muscles that can lead to poor respiratory function during sleep and negatively affect sleep quality. The impact of respiratory muscle training (RMT) on sleep quality, as assessed by overnight polysomnography (PSG), is yet to be determined among the spinal cord-injured population. This case report describes the effects of 10 weeks of RMT on the sleep quality of a 38-year-old male with cervical SCI.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  The subject completed overnight PSG, respiratory muscle strength assessment, and subjective sleepiness assessment before and after 10 weeks of RMT. The post-test results indicated improvements in sleep quality (e.g. fewer electroencephalographic (EEG) arousals during sleep) and daytime sleepiness scores following RMT.
  
  
  CONCLUSIONS
  Respiratory activity has been proven to impact EEG arousal activity during sleep. Arousals during sleep lead to a fragmented sleeping pattern and affect sleep quality and daytime function. Our subject presented with a typical sleep complaint of snoring and excessive sleepiness. The subject's pre-test PSG demonstrated a large number of arousals during sleep. It is important for all individuals complaining of problems during sleep or daytime problems associated with sleep (i.e. excessive daytime sleepiness) to seek medical attention and proper evaluation.
authors.affiliation: Department of Respiratory Care, Texas State University-San Marcos, USA. cr23@txstate.edu
authors.forename: Chris
authors.initials: C
authors.lastname: Russian
authors.forename: Lyn
authors.initials: L
authors.lastname: Litchke
authors.forename: John
authors.initials: J
authors.lastname: Hudson
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D017286:Polysomnography / Q000379:methods; D055070:Resistance Training / Q000379:methods*; D012129:Respiratory Function Tests / Q000379:methods; D012132:Respiratory Muscles / Q000503:physiopathology*; D012890:Sleep / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*