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Lambert C, Maria JD, Denys P, Even A, Welniarz A, Hartley S, Prigent H, Leotard A, Joussain C. Nocturia and obstructive sleep apnea in spinal cord injured patients - a cohort study. World J Urol 2024; 42:519. [PMID: 39259389 DOI: 10.1007/s00345-024-05190-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 07/20/2024] [Indexed: 09/13/2024] Open
Abstract
PURPOSE To describe the prevalence of nocturia and obstructive sleep apnea (OSA) in a cohort of spinal cord injury (SCI) patients and to describe their association. Additionally, to assess clinical and urodynamic data explaining nocturia and to evaluate the effect of OSA management with continuous positive airway pressure (CPAP). METHOD Retrospective analysis of data from patients with SCI followed in a tertiary care rehabilitation center with a specialized sleep and neuro-urology units. All adult SCI patients who underwent urodynamic assessment before polysomnography (PSG) between 2015 and 2023 were eligible. Subjective (nocturia) and objective data (urodynamic data, polysomnography, CPAP built-in software) were collated from the Handisom database (database register no. 20200224113128) and the medical records of SCI patients. Statistical testing used Mann-Whitney test for non-parametric variables, Fisher's exact test for contingency analysis and the Spearman correlation test to assess correlations. A p-value < 0.05 was considered significant. Statistical analyses were performed using GraphPad Prism v9. RESULTS 173 patients (131 males, 42 females) were included. The majority of patients were paraplegic (n = 111 (64,2%)) and had complete lesions (n = 75 (43,4%)). A total of 100 patients had nocturia (57,5%). The prevalence of OSA (Apnea Hypopnea Index (AHI) ≥ 15/h) in the studied population was 61,9%. No correlation was found between nocturia and OSA. A significant difference was observed between patients with and without nocturia in terms of the presence of neurogenic detrusor overactivity (p = 0,049), volume at the first detrusor contraction (p = 0,004) and the bladder functional capacity (p < 0,001). CONCLUSION Nocturia and OSA are highly prevalent in patients with SCI, but no statistical association was found between these two disorders. A prospective study focusing on nocturnal polyuria will be needed to assess the impact of OSA on lower urinary tract symptoms in SCI patients.
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Affiliation(s)
- C Lambert
- Service de Médecine Physique et Réadaptation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - J Di Maria
- Service de Physiologie et d'Explorations Fonctionnelles, GHU Paris Saclay, AP-HP, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, Garches, 92380, France
| | - P Denys
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - A Even
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - A Welniarz
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - S Hartley
- Service de Physiologie et d'Explorations Fonctionnelles, GHU Paris Saclay, AP-HP, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, Garches, 92380, France
| | - H Prigent
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - A Leotard
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - Charles Joussain
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France.
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France.
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Cao Y, Wu H, Shi S, Xie D. Effects of mindfulness-based stress reduction therapy for sleep quality and perceived stress in patients with spinal cord injury. Explore (NY) 2024; 20:103037. [PMID: 39163704 DOI: 10.1016/j.explore.2024.103037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/17/2024] [Accepted: 08/05/2024] [Indexed: 08/22/2024]
Abstract
OBJECTIVE To explore the effect of the mindfulness-based stress reduction (MBSR) practice on sleep quality and perceived stress in patients with spinal cord injury (SCI). METHOD A total of 104 patients with SCI (diagnosed via imaging and clinical symptoms) admitted to our hospital between January 2020 and December 2022 were selected as the study participants. The patients were randomly divided into two groups: the MBSR (observation) group and the control group. The observation group received MBSR therapy and routine nursing, and the control group received music training therapy and routine nursing. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and the perceived stress score was used to evaluate stress experienced by the patients at three timepoints: before intervention, 4 weeks and 8weeks after intervention. RESULTS Compared with before intervention, the PSQI scores of both the control group and intervention group participants significantly decreased after intervention(P < 0.01). Compared with the 4 weeks after intervention, the PSQI scores of both groups of participants decreased in the 8 weeks after intervention(P < 0.01). There was a significant difference in PSQI scores between the two groups of participants at 4 and 8 weeks after intervention(P < 0.01). Compared with before intervention, the average perceived stress score of both the control group and intervention group participants significantly decreased after intervention(P < 0.05). Compared with the 4 weeks after intervention, the average perceived stress score of both groups of participants decreased in the 8 weeks after intervention(P < 0.01). There was a significant difference in average perceived stress score between the two groups of participants at 4(P < 0.05) and 8 weeks(P < 0.01) after intervention(P < 0.01). CONCLUSION The use of MBSR therapy could effectively improve patient sleep quality and reduce perceived stress.
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Affiliation(s)
- Yan Cao
- Department of rehabilitation medicine, Wuxi Central Rehabilitation Hospital, 214151, Wuxi, China
| | - Huihong Wu
- Department of rehabilitation medicine, Wuxi Central Rehabilitation Hospital, 214151, Wuxi, China
| | - Sujuan Shi
- Department of rehabilitation medicine, Wuxi Central Rehabilitation Hospital, 214151, Wuxi, China
| | - Dan Xie
- Department of rehabilitation medicine, Wuxi Central Rehabilitation Hospital, 214151, Wuxi, China.
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Zhao F, Balthazaar S, Hiremath SV, Nightingale TE, Panza GS. Enhancing Spinal Cord Injury Care: Using Wearable Technologies for Physical Activity, Sleep, and Cardiovascular Health. Arch Phys Med Rehabil 2024:S0003-9993(24)01076-1. [PMID: 38972475 DOI: 10.1016/j.apmr.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/09/2024]
Abstract
Wearable devices have the potential to advance health care by enabling real-time monitoring of biobehavioral data and facilitating the management of an individual's health conditions. Individuals living with spinal cord injury (SCI) have impaired motor function, which results in deconditioning and worsening cardiovascular health outcomes. Wearable devices may promote physical activity and allow the monitoring of secondary complications associated with SCI, potentially improving motor function, sleep, and cardiovascular health. However, several challenges remain to optimize the application of wearable technologies within this population. One is striking a balance between research-grade and consumer-grade devices in terms of cost, accessibility, and validity. Additionally, limited literature supports the validity and use of wearable technology in monitoring cardio-autonomic and sleep outcomes for individuals with SCI. Future directions include conducting performance evaluations of wearable devices to precisely capture the additional variation in movement and physiological parameters seen in those with SCI. Moreover, efforts to make the devices small, lightweight, and inexpensive for consumer ease of use may affect those with severe motor impairments. Overcoming these challenges holds the potential for wearable devices to help individuals living with SCI receive timely feedback to manage their health conditions and help clinicians gather comprehensive patient health information to aid in diagnosis and treatment.
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Affiliation(s)
- Fei Zhao
- Department of Health Care Sciences, Program of Occupational Therapy, Wayne State University, Detroit, MI; John D. Dingell VA Medical Center, Research and Development, Detroit, MI
| | - Shane Balthazaar
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada; Department of Cardiology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Birmingham, United Kingdom
| | - Shivayogi V Hiremath
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, PA
| | - Tom E Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
| | - Gino S Panza
- Department of Health Care Sciences, Program of Occupational Therapy, Wayne State University, Detroit, MI; John D. Dingell VA Medical Center, Research and Development, Detroit, MI.
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Berlowitz DJ, Graco M. Not there yet; the challenge of treating sleep-disordered breathing in people living with spinal cord injury/disease. Sleep 2024; 47:zsae068. [PMID: 38452041 PMCID: PMC11082463 DOI: 10.1093/sleep/zsae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Indexed: 03/09/2024] Open
Affiliation(s)
- David J Berlowitz
- Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Marnie Graco
- Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
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Aboussouan LS, Badr MS, Sankari A. The quest for accurate evaluation and treatment of sleep disordered breathing in spinal cord injury. Sleep 2023; 46:zsad264. [PMID: 37801685 DOI: 10.1093/sleep/zsad264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Indexed: 10/08/2023] Open
Affiliation(s)
- Loutfi S Aboussouan
- Respiratory and Neurological Institutes, Cleveland Clinic, Cleveland, OH, USA
| | - M Safwan Badr
- Department of Internal Medicine, Liborio Tranchida, MD, Endowed Professor of Medicine, Wayne State University School of Medicine, University Health Center, Detroit, MI, USA
| | - Abdulghani Sankari
- Sleep Research Laboratory, John D. Dingell Veterans Affairs Medical Center, Wayne State University, Detroit, MI, USA
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