title: Subjective sleep disturbances and quality of life in chronic tetraplegia.
abstract: METHODS
  This is a cross-sectional survey.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the subjective sleep disturbances and quality of life in chronic tetraplegia.
  
  
  METHODS
  This study was conducted in a community sample from Victoria, Australia.
  
  
  METHODS
  People with tetraplegia were mailed a survey battery including the following: demographic questions; Karolinska Sleepiness Scale (KSS); Basic Nordic Sleepiness Questionnaire; Functional Outcomes of Sleep Questionnaire (FOSQ); Multivariate Apnoea Prediction Index and Assessment of Quality of Life (AQoL) Questionnaire. Scores were compared with the best available normative data.
  
  
  RESULTS
  A total of 163 of 424 (38%) surveys were returned (77% male; 39% sensory and motor complete; mean age±s.d.=46±14 years; mean years since injury=11±8 years). The AQoL health utility score (0.31±0.29) was significantly lower than published population norms. FOSQ total (17.55±2.57) and KSS (3.93±2.27) scores were no different from the best available population data. People with tetraplegia reported worse sleep habits, symptoms and quality than a normal population, as indicated on 17 of 21 questions on the Basic Nordic Sleep Questionnaire. Multivariate analysis found that greater injury severity (coefficient (95% CI)=0.14 (0.10, 0.18)), increasing age (-0.004 (-0.008, -0.001)) and worse sleep symptoms (-0.005 (-0.009, -0.0003)) were all significantly associated with reduced quality of life.
  
  
  CONCLUSIONS
  People with chronic tetraplegia experience more subjective sleep problems and worse quality of life than their able-bodied counterparts. Quality of life is related to injury severity, age and sleep symptoms. Treating the sleep disorders experienced by people living with tetraplegia has the potential to improve their health and well-being.
authors.affiliation: Institute for Breathing and Sleep, Bowen Centre, Austin Hospital, Heidelberg, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Spong
authors.affiliation: Institute for Breathing and Sleep, Bowen Centre, Austin Hospital, Heidelberg, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Graco
authors.affiliation: Spinal Research Institute, Melbourne, Australia.
authors.forename: D J
authors.initials: DJ
authors.lastname: Brown
authors.affiliation: Institute for Breathing and Sleep, Bowen Centre, Austin Hospital, Heidelberg, Victoria, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Schembri
authors.affiliation: Institute for Breathing and Sleep, Bowen Centre, Austin Hospital, Heidelberg, Victoria, Australia.
authors.forename: D J
authors.initials: DJ
authors.lastname: Berlowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000150:complications* / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D055815:Young Adult