title: Sleep apnea and periodic leg movements in the first year after spinal cord injury.
abstract: BACKGROUND
  Sleep disturbances are frequently reported by patients with spinal cord injury (SCI). Studies have shown an increased incidence of sleep-disordered breathing (SDB) and periodic leg movements during sleep (PLMS) in people with stable long-term SCI.
  
  
  METHODS
  This was a prospective observational study in order to evaluate the features and possible predisposing factors of SDB and PLMS in a heterogenic population of consecutive SCI patients admitted at the Spinal Unit of the Niguarda Hospital within the first year after injury. Each patient underwent a clinical assessment, full polysomnography, and arterial blood gas analysis before and immediately after sleep. Multiple logistic regressions were applied in order to evaluate factors associated with SDB and PLMS.
  
  
  RESULTS
  Thirty-five (15 tetraplegic and 20 paraplegic) patients were enrolled. Nine patients (25.7%) had an obstructive SDB and 10 (28.6%) had PLMS. The frequency of SDB was higher in tetraplegic with respect to paraplegic patients (Wald statistic: 7.71; P = 0.0055), whereas PLMs were significantly more frequent in patients with an incomplete motor lesion than in subjects with a complete motor lesion (Wald statistic: 6.14; P = 0.013).
  
  
  CONCLUSIONS
  This study confirms a high frequency of SDB and PLMS in SCI patients in the first year following injury. Independently from possible sub-acute and chronic clinical variables, the level and the completeness of the spinal cord lesion are the main factors associated respectively with an early development of SDB and PLMS.
authors.affiliation: Centre of Sleep Medicine, Centre for Epilepsy Surgery "C. Munari", Niguarda Hospital, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Proserpio
authors.affiliation: Centre of Sleep Medicine, Centre for Epilepsy Surgery "C. Munari", Niguarda Hospital, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lanza
authors.affiliation: Centre of Sleep Medicine, Centre for Epilepsy Surgery "C. Munari", Niguarda Hospital, Milan, Italy.
authors.forename: Katrina
authors.initials: K
authors.lastname: Sambusida
authors.affiliation: Institute of Neurology, "Humanitas" Clinical Institute, Milan, Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Fratticci
authors.affiliation: Spinal Cord Unit, Niguarda Hospital, Milan, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Frigerio
authors.affiliation: Emergency Department, Niguarda Hospital, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Sommariva
authors.affiliation: Spinal Cord Unit, Niguarda Hospital, Milan, Italy.
authors.forename: Enrica Giuliana
authors.initials: EG
authors.lastname: Stagni
authors.affiliation: Spinal Cord Unit, Niguarda Hospital, Milan, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Redaelli
authors.affiliation: Institute of Bioimaging and Molecular Physiology, Genoa Unit, National Research Council, Genoa, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Carli
authors.affiliation: Centre of Sleep Medicine, Centre for Epilepsy Surgery "C. Munari", Niguarda Hospital, Milan, Italy; Institute of Bioimaging and Molecular Physiology, Genoa Unit, National Research Council, Genoa, Italy. Electronic address: Lino.nobili@ospedaleniguarda.it.
authors.forename: Lino
authors.initials: L
authors.lastname: Nobili
mesh_terms: D000328:Adult; D001784:Blood Gas Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D010264:Paraplegia / Q000150:complications; D017286:Polysomnography; D011446:Prospective Studies; D011782:Quadriplegia / Q000150:complications; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors; D055815:Young Adult
keywords: Hypoventilation; Obstructive sleep apnea; Paraplegia; Periodic leg movements; Sleep-disordered breathing; Spinal cord injury; Tetraplegia