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Project

Psychosocial, cognitive, and behavioral consequences of sleep-disordered breathing in SCI people

Funder: Craig H Neilsen Foundation

Funding period
USD 200 K
Funding amount
Abstract
Spinal cord injury (SCI) is a potentially catastrophic event for individuals who may sustain motor, sensory, and autonomic deficit, as well as secondary conditions including sleep-related breathing disorders (SRBDs). The SRBDs include central, obstructive and mixed sleep apnea that can occur in up to 50% of the paraplegics and up to 91% of the motor complete tetraplegics. Although the frequency of SRBDs after SCI is much greater than in able-bodied people, this condition is still a largely under-recognized in the SCI population. Several risk factors have been claimed in association with SRBDs, while the underlying mechanisms of post-SCI SRBD are poorly understood. In addition to indicating a major public health issue, under-recognized and untreated sleep-related breathing disorders most likely represent a serious risk factor for stroke, myocardial infarction, metabolic disorder, renal dysfunction, hepatic disease, mood disorders, cognitive impairment, among other medical conditions in the SCI population.With this, we hypothesize that regular use of continuous positive airway pressure (CPAP) for treatment of moderate-to-severe SRBDs in individuals living with SCI significantly improve their fatigue, depressive symptoms, anxiety, cognitive impairment, quality of life, and social and work participation. This 2-year research project will include: (i) a single-arm clinical trial to evaluate the efficacy of nightly use of CPAP for 4 consecutive months in the management of moderate-to-severe SRBDs among 24 adults with subacute to chronic (at least 2 months after injury), cervical or thoracic (injury level at C5 to T10), complete or incomplete (AIS-A/B/C) SCI; and (ii) a qualitative study of the challenges experienced by the 24 people with SCI who undergo an unattended-hospital or home-based sleep study for diagnosis of SRBDs followed by CPAP therapy. The outcome measures for the clinical trial will include the Fatigue Severity Scale; Epworth sleepiness score; Medical Outcomes Study Sleep Scale; Depression, Anxiety & Stress Scales- 21; Montreal Cognitive Assessment with alternative visuospatial tasks for the figure and clock draw due to patients’ motor limitations; Craig handicap assessment and recording technique; and Health-related quality of life using SF-36 questionnaire. The study design, sample size estimation and feasibility analysis indicate that the proposed research project can properly answer those clinically relevant research questions.This research project will, for the first, examine the efficacy of CPAP therapy in improving psychosocial, neurocognitive and behavioral consequences of moderate-to-severe SRBDs in people living with SCI. Moreover, this novel research project will also identify the challenges and potential solutions to facilitate the diagnosis and treatment of SRBDs in people with SCI. Overall, our research project has the potential to ultimately improve fatigue, mood, cognition, quality of life, and social and work participation of people living with SCI, by examining under-explored links with the SRBDs. (CHN: PSR chn:wdg)
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System

Categories
  • FOR (ANZSRC)

    1103 Clinical Sciences

  • FOR (ANZSRC)

    1117 Public Health and Health Services

  • FOR (ANZSRC)

    1701 Psychology

  • RCDC

    Injury (total) Accidents/Adverse Effects

  • RCDC

    Injury - Trauma - (Head and Spine)

  • RCDC

    Mental Health

  • RCDC

    Neurosciences

  • RCDC

    Lung

  • RCDC

    Depression

  • RCDC

    Mind and Body

  • RCDC

    Rehabilitation

  • RCDC

    Sleep Research

  • RCDC

    Spinal Cord Injury

  • RCDC

    Behavioral and Social Science

  • RCDC

    Clinical Research

  • RCDC

    Neurodegenerative

  • HRCS HC

    Neurological

  • HRCS HC

    Mental Health

  • Health Research Areas

    Clinical

  • Broad Research Areas

    Clinical Medicine and Science