Is Sleep Disordered Breathing Confounding Rehabilitation Outcomes in Spinal Cord Injury Research?

Abstract

The purpose of this article is to highlight the importance of considering sleep-disordered breathing (SDB) as a potential confounder to rehabilitation research interventions in spinal cord injury (SCI). Sleep disordered breathing is highly prevalent in SCI with increased prevalence in those with higher and more severe lesions, and the gold standard treatment with continuous positive airway pressure remains problematic. Despite the high prevalence, SDB is often untested and untreated in individuals with SCI. In individuals without SCI, SDB is known to negatively impact physical function and many of the physiological systems that negatively impact physical rehabilitation in SCI. Thus, due to the high prevalence, under testing, low treatment adherence, and known negative impact on the physical function, it is contended that underdiagnosed SDB in SCI may be confounding physical rehabilitation research studies in individuals with SCI. Studies investigating the impact of treating SDB and its impact on physical rehabilitation in SCI were unable to be located. Thus, studies investigating the likely integrated relationship among physical rehabilitation, SDB, and proper treatment of SDB in SCI are needed. Due to rapid growth in both sleep medicine and physical rehabilitation intervention research in SCI, the authors contend it is the appropriate time to begin the conversations and collaborations between these fields. Here a general overview of SDB and physical training modalities is discussed, and how SDB could be impacting these studies.