title: Dysfunctional sleep in persons with spinal cord injuries and disorders.
abstract: METHODS
  Cross-sectional survey of veterans with spinal cord injuries and disorders (SCI/D).
  
  
  OBJECTIVE
  To describe sleep dysfunction (independent of sleep apnea) in persons with traumatic and non-traumatic SCI/D, and to examine characteristics and health outcomes independently associated with sleep dysfunction unrelated to sleep apnea.
  
  
  METHODS
  Seven Veterans Affairs SCI care facilities in the United States.
  
  
  METHODS
  Mailed cross-sectional survey with follow-up calls completed by end of 2008. Bivariate analyses to compare measures outcomes in persons with SCI/D who were dysfunctional sleepers vs those who were not. Multivariate logistic regression used to identify variables independently associated with dysfunctional sleep in veterans with SCI/D.
  
  
  RESULTS
  Overall, 49% of the sample had sleep dysfunction unrelated to sleep apnea. In this subgroup, bivariate analyses showed that a greater proportion of dysfunctional sleepers than non-dysfunctional sleepers were current smokers, had problems with drinking alcohol, hypertension, asthma, chronic obstructive pulmonary disease (COPD) and problematic weight gain. Variables independently associated with higher odds of dysfunctional sleep included white race, being a current smoker, problems with drinking alcohol, asthma, COPD and problematic weight gain.
  
  
  CONCLUSIONS
  Consistent with epidemiological evidence for the general population, we found significant associations of sleep dysfunction with weight gain, smoking, alcohol misuse and select chronic conditions (COPD, asthma). Sustained sleep dysfunction may contribute to health deterioration and mortality, highlighting the need to address the high prevalence of sleep dysfunction (independent of sleep apnea) in persons with SCI/D. In particular, efforts aimed at modifying problematic weight gain, alcohol misuse and smoking are warranted in this cohort to improve sleep.
authors.affiliation: Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, IL 60141, USA. Sherri.LaVela@va.gov
authors.forename: S L
authors.initials: SL
authors.lastname: LaVela
authors.forename: S P
authors.initials: SP
authors.lastname: Burns
authors.forename: B
authors.initials: B
authors.lastname: Goldstein
authors.forename: S
authors.initials: S
authors.lastname: Miskevics
authors.forename: B
authors.initials: B
authors.lastname: Smith
authors.forename: F M
authors.initials: FM
authors.lastname: Weaver
mesh_terms: D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D013118:Spinal Cord Diseases / Q000150:complications* / Q000453:epidemiology*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology; D014728:Veterans