Data from: Sleep disordered breathing is associated with brain vascular reactivity in spinal cord injury

Objective: Our goal was to determine the population-level odds of individuals with SCI experiencing fatigue and sleep apnea, to elucidate relationships with level and severity of injury, and to examine associations with abnormal cerebrovascular responsiveness. Methods: We used population-level data, meta-analyses, and primary physiological assessments to provide a large-scale integrated assessment of sleep-related complications after SCI. Population-level and meta-analyses included more than 60,000 able-bodied individuals and more than 1,800 individuals with SCI. Physiological assessments were completed on a homogenous sample of individuals with cervical SCI, and matched controls. We examined the prevalence of 1) self-reported chronic fatigue, 2) clinically-identified sleep apnea, and 3) cerebrovascular responsiveness to changing CO2. Results: Logistic regression revealed a 7-fold elevated odds of chronic fatigue after SCI [OR: 7.9, 95% CI: 3.5-16.2], and that fatigue and trouble sleeping are correlated with the level and severity of injury. We further show that those with SCI experience elevated risk of clinically-defined sleep-disordered breathing in more than 600 individuals with SCI [pooled OR: 3.1, 95% CI: 1.3-7.5]. We confirmed that individuals with SCI experience a high rate of clinically-defined sleep-apnea using primary polysomnography assessments. We then provide evidence using syndromic analysis that sleep-disordered breathing is a factor strongly associated with impaired cerebrovascular responsiveness to CO2 in patients with SCI. Conclusions: Individuals with SCI have an increased prevalence of sleep-disordered breathing, which may partially underpin their increased risk of stroke. There is thus a need to integrate sleep-related breathing examinations into routine care for individuals with SCI.Supplemental InformationTable e-4Table e-