CPAP Therapy for 4 Months Improves Sleep Quality, Daytime Alertness, Fatigue, and Mental Health in People with Chronic Spinal Cord Injury and Moderate-to-Severe Sleep-Related Breathing Disorder: The Preliminary Results of an Ongoing Prospective Study. (S38.002)

Abstract

<h3>Objective:</h3> To examine the cognitive and psychological effects of continuous positive airway pressure (CPAP) therapy in people with chronic spinal cord injury (SCI) and moderate-to-severe sleep-related breathing disorder (SRBD). <h3>Background:</h3> SRBDs are common but under-recognized after SCI. <h3>Design/Methods:</h3> An ongoing single-arm clinical trial (NCT04007380) aims to evaluate the effects of 4 months of CPAP therapy on cognition and mental health in people with SCI who were diagnosed with moderate-to-severe SRBD. Outcomes included the Epworth Sleepiness Scale, Medical Outcomes Study Sleep Scale, Fatigue Severity Scale, Depression, Anxiety &amp; Stress Scale-21, and Montreal Cognitive Assessment (MoCA). The participants shared their experience in a 1-hour semi-structured interview (qualitative analysis). <h3>Results:</h3> By September 2022, we screened 31 individuals (10 females, 21 males; ages range: 37–79 years; mean age: 58.4 years) with complete motor (n=14) or incomplete SCI at cervical (n=20) or thoracic level. Time from SCI onset varied from 4 to 793 months (mean time: 190.5 months). Of the 31 screened participants, the apnea-hypopnea index (AHI) varied from 2.6 to 83.7 events per hour (mean AHI: 23.0). Of the 24 individuals who initiated CPAP therapy, 11 individuals have completed it, whereas three individuals withdrew from the study. The overall mean adherence rate to CPAP was 78.6%; mean nighttime CPAP usage was approximately 5 hours. Daytime sleepiness (p=0.003) and sleep quality (p&lt;0.001) significantly improved with CPAP therapy. Fatigue significantly decreased with CPAP therapy (p=0.048). Mental health indicators improved with CPAP therapy (p=0.049). There was a numeric increase in MoCA scores, but this did not reach significance yet (p=0.160). All 11 participants confirmed that CPAP therapy had a positive impact in their lives. <h3>Conclusions:</h3> Our preliminary results suggest that 4 months of CPAP therapy significantly improves sleep quality, and reduces daytime sleepiness, fatigue, stress, anxiety and mood in people with chronic SCI. The participants’ adherence to CPAP therapy was high (78.6%). <b>Disclosure:</b> The institution of Dr. Furlan has received research support from Wings for Life Spinal Cord Research Foundation. The institution of Dr. Furlan has received research support from Craig H Neilsen Foundation. The institution of Dr. Furlan has received research support from Ontario Neurotrauma Foundation. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from J P Bickell Foundation. The institution of Dr. Furlan has received research support from Praxis Spinal Cord Institute. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. Dr. Hitzig has nothing to disclose. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Paladin Labs. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Boulos has received research support from Interaxon. The institution of Dr. Boulos has received research support from The Mahaffy Family Research Fund. The institution of Dr. Boulos has received research support from Canadian Institutes of Health Research. The institution of Dr. Boulos has received research support from Slamen-Fast New Initiatives in Neurology Award. The institution of Dr. Boulos has received research support from Green Mountain . Dr. Boulos has received personal compensation in the range of $5,000-$9,999 for serving as a speaker with Jazz Pharmaceuticals.