This ongoing study aims to examine the potential cognitive and psycho-social benefits of continuous positive airway pressure (CPAP) therapy in people with chronic spinal cord injury (SCI) and moderate-to-severe sleep apnea (SA).
This study included adults with chronic SCI who underwent a 4-month trial of CPAP therapy for management of recently diagnosed moderate-to-severe SA. Outcome measures included the Epworth Sleepiness Scale (ESS), Medical Outcomes Study Sleep Scale (MOS-SS), Fatigue Severity Scale (FSS), Depression, Anxiety & Stress Scale-21 (DASS-21), Montreal Cognitive Assessment (MoCA), SF-36, and Craig Handicap Assessment & Reporting Technique (CHART). The participants were also asked about their lived experience before and after CPAP trial (qualitative analysis).
By February 2023, we screened 33 individuals (10 females, 23 males; age range: 37-79 years; mean age: 58.3 years) with motor complete (n=15) or incomplete SCI at cervical (n=22) or thoracic levels. Time since SCI varied from 4 to 793 months. The apnea-hypopnea index (AHI) varied from 2.6 to 83.7 events/hour. Of the 33 individuals, 25 participants with moderate-to-severe SA initiated CPAP therapy; 19 individuals have completed the CPAP trial. Daytime sleepiness and sleep quality, fatigue and quality of life significantly improved with CPAP therapy. There was a trend for improvement of cognitive, mental health and participation scores, but they have not reached significance yet (p=0.079, p=0.207, p=0.221, respectively).
Our preliminary results suggest that 4 months of CPAP therapy significantly improves sleep quality, and quality of life, and mitigates daytime sleepiness, fatigue, and anxiety in people with chronic SCI.
