Treatment of Sleep Apnea in Patients With Cervical Spinal Cord Injury
John D. Dingell VA Medical Center
Summary
This study will investigate potential therapeutic approaches for sleep-disordered breathing (SDB) in patients with chronic cervical spine injury (\>6 months post-injury).
Description
Patients with cervical spinal cord injury demonstrate central sleep disordered breathing manifesting as central sleep apnea or a periodic breathing pattern. Understanding the causes of central sleep apnea may be critically important to understanding upper airway obstruction in susceptible individuals, given the critical role of ventilatory motor output in maintaining upper airway patency as evidenced by upper airway narrowing or occlusion at the nadir of ventilator drive during periodic breathing. This study is likely to identify therapeutic strategies that could be tested in large clinical tr…
Eligibility
- Age range
- 18–89 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: 1. healthy adults between the ages of 18 - 89 2. chronic spinal cord injury patients (T6 and above), \> 3 months since injury and not on mechanical ventilation, and have not received mechanical ventilation via tracheostomy in the past. Exclusion Criteria: 1. subjects ≤ 17 yrs old 2. Pregnant and lactating females 3. History of head trauma that resulted in neurological symptoms or loss of consciousness 4. advanced heart, lung, metabolic, liver or chronic kidney disease. 5. severe obstructive or restrictive respiratory defect by PFTs or history of tracheostomy 6. extreme o…
Interventions
- ProcedureAcute episodic hypoxia
The subjects will undergo 30 minutes of baseline monitoring followed by 15 episodes of one minute of episodic hypoxia with supplemental CO2 to maintain isocapnia. This is followed by a 45 minute recovery period.
- ProcedureSupplemental oxygen
Supplemental oxygen therapy for 6 weeks
- DrugTrazodone
100mg before bedtime
- DrugPlacebo
One placebo pill before-bedtime
- ProcedureSham
Room air will be administered instead of episodic hypoxia or supplemental oxygen..
Location
- John D. Dingell VA Medical CenterDetroit, Michigan