Home-Based Diagnosis and Management of Sleep-Related Breathing Disorders in Spinal Cord Injury
Obstructive Sleep Apnea, Hypercapnia, Spinal Cord Injury
About this trial
This is an interventional diagnostic trial for Obstructive Sleep Apnea focused on measuring obstructive sleep apnea, sleep-disordered breathing, hypercapnia, spinal cord injury
Eligibility Criteria
Inclusion Criteria:
- 18 years or older
- C1-T6 spinal cord injury for at least 3 months
- living within 100 miles of Ann Arbor, Michigan, USA
Exclusion Criteria:
- unable to provide informed consent
- comorbid condition that limits life expectancy to less than 1 year
- ventilator-dependent
- established diagnosis of sleep-disordered breathing
- prior use of noninvasive positive pressure ventilation (CPAP or BiPAP) for any reason (temporary suse of noninvasive ventilation during a hospitalization is permissible if it was discontinued more than 3 months prior to enrollment)
- active duty military personnel
Sites / Locations
- University of Michigan Health System
Arms of the Study
Arm 1
Arm 2
Arm 3
No Intervention
Experimental
Experimental
Normal sleep breathing
BiPAP -Auto for sleep apnea
BiPAP (AVAPS) for nocturnal hypoventilation
Home-based sleep studies indicate no obstructive sleep apnea or nocturnal hypoventilation. No intervention.
Patients whose home-based sleep study detects obstructive sleep apnea, but no nocturnal hypoventilation. Noninvasive ventilatory support will be prescribed according to standard clinical criteria.
Patients whose home-based sleep study detects nocturnal hypoventilation in the presence or absence of obstructive sleep apnea. Noninvasive ventilatory support will be prescribed according to standard clinical criteria. BiPAP/AVAPS (Phillips Respironics) is worn with a mask interface of the subject's choice. It is specifically designed to treat nocturnal hypoventilation.