University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Science
  • School of Mathematics and Statistics
  • School of Mathematics and Statistics - Research Publications
  • View Item
  • Minerva Access
  • Science
  • School of Mathematics and Statistics
  • School of Mathematics and Statistics - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    Positive airway pressure for sleep-disordered breathing in acute quadriplegia: a randomised controlled trial

    Thumbnail
    Download
    Published version (453.0Kb)

    Citations
    Scopus
    Web of Science
    Altmetric
    5
    5
    Author
    Berlowitz, DJ; Schembri, R; Graco, M; Ross, JM; Ayas, N; Gordon, I; Lee, B; Graham, A; Cross, SV; McClelland, M; ...
    Date
    2019-03-01
    Source Title
    Thorax
    Publisher
    BMJ PUBLISHING GROUP
    University of Melbourne Author/s
    Gordon, Ian; Berlowitz, David; Graco, Marnie; Schembri, Rachel
    Affiliation
    School of Mathematics and Statistics
    Physiotherapy
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Berlowitz, D. J., Schembri, R., Graco, M., Ross, J. M., Ayas, N., Gordon, I., Lee, B., Graham, A., Cross, S. V., McClelland, M., Kennedy, P., Thumbikat, P., Bennett, C., Townson, A., Geraghty, T. J., Pieri-Davies, S., Singhal, R., Marshall, K., Short, D. ,... Whittall, C. (2019). Positive airway pressure for sleep-disordered breathing in acute quadriplegia: a randomised controlled trial. THORAX, 74 (3), pp.282-290. https://doi.org/10.1136/thoraxjnl-2018-212319.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253326
    DOI
    10.1136/thoraxjnl-2018-212319
    Abstract
    RATIONALE: Highly prevalent and severe sleep-disordered breathing caused by acute cervical spinal cord injury (quadriplegia) is associated with neurocognitive dysfunction and sleepiness and is likely to impair rehabilitation. OBJECTIVE: To determine whether 3 months of autotitrating CPAP would improve neurocognitive function, sleepiness, quality of life, anxiety and depression more than usual care in acute quadriplegia. METHODS AND MEASUREMENTS: Multinational, randomised controlled trial (11 centres) from July 2009 to October 2015. The primary outcome was neurocognitive (attention and information processing as measure with the Paced Auditory Serial Addition Task). Daytime sleepiness (Karolinska Sleepiness Scale) was a priori identified as the most important secondary outcome. MAIN RESULTS: 1810 incident cases were screened. 332 underwent full, portable polysomnography, 273 of whom had an apnoea hypopnoea index greater than 10. 160 tolerated at least 4 hours of CPAP during a 3-day run-in and were randomised. 149 participants (134 men, age 46±34 years, 81±57 days postinjury) completed the trial. CPAP use averaged 2.9±2.3 hours per night with 21% fully 'adherent' (at least 4 hours use on 5 days per week). Intention-to-treat analyses revealed no significant differences between groups in the Paced Auditory Serial Addition Task (mean improvement of 2.28, 95% CI -7.09 to 11.6; p=0.63). Controlling for premorbid intelligence, age and obstructive sleep apnoea severity (group effect -1.15, 95% CI -10 to 7.7) did not alter this finding. Sleepiness was significantly improved by CPAP on intention-to-treat analysis (mean difference -1.26, 95% CI -2.2 to -0.32; p=0.01). CONCLUSION: CPAP did not improve Paced Auditory Serial Addition Task scores but significantly reduced sleepiness after acute quadriplegia. TRIAL REGISTRATION NUMBER: ACTRN12605000799651.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [45689]
    • Physiotherapy - Research Publications [391]
    • School of Mathematics and Statistics - Research Publications [680]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors