Abstract
Patients with spinal cord injury (SCI) have an increased risk of sleep-disordered breathing (SDB), which can lead to serious comorbidities and impact patients’ recovery and quality of life. However, sleep tests are rarely performed on SCI patients, given their multiple health needs and the cost and complexity of diagnostic equipment. The objective of this study was to use a novel smartphone system as a simple non-invasive tool to monitor SDB in SCI patients. We recorded pulse oximetry, acoustic, and accelerometer data using a smartphone during overnight tests in 19 SCI patients and 19 able-bodied controls. Then, we analyzed these signals with automatic algorithms to detect desaturation, apnea, and hypopnea events and monitor sleep position. The apnea–hypopnea index (AHI) was significantly higher in SCI patients than controls (25 ± 15 vs. 9 ± 7, p < 0.001). We found that 63% of SCI patients had moderate-to-severe SDB (AHI ≥ 15) in contrast to 21% of control subjects. Most SCI patients slept predominantly in supine position, but an increased occurrence of events in supine position was only observed for eight patients. This study highlights the problem of SDB in SCI and provides simple cost-effective sleep monitoring tools to facilitate the detection, understanding, and management of SDB in SCI patients.
Highlights
Sleeping, like breathing, is an action that we undertake throughout our entire life.We spend approximately 30% of our time sleeping [1], and this is strictly necessary since sleep is the natural state of rest and self-regulation of the organism
spinal cord injury (SCI) patients admitted to hospital for rehabilitation, traumatic or non-traumatic in origin, less than 1 year post-injury, and complete or incomplete injuries classified as A–D according to the American Spinal Injury Association Impairment Scale (AIS) [38]
We describe in more detail the results in terms of oxygen saturation, apneas, and hypopneas detected from acoustic signals, sleep position measured from accelerometer data, and prevalence of oral breathing
Summary
Like breathing, is an action that we undertake throughout our entire life. We spend approximately 30% of our time sleeping [1], and this is strictly necessary since sleep is the natural state of rest and self-regulation of the organism. Several diseases can affect sleep quality, producing symptoms of varying severity. These medical conditions, which are called sleep disorders, are highly prevalent in the general population. One of the most common sleep disorders is sleep apnea syndrome, referred to as sleep-disordered breathing (SDB). Sleep apnea is an underdiagnosed medical condition [3,4] that is characterized by repeated episodes of absence (apnea) or reduction (hypopnea) in airflow during sleep, which can be either obstructive or central in origin
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