{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:21:37Z","timestamp":1790799697852,"version":"4.1.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>Over 80% of people with tetraplegia have sleep-disordered breathing (SDB), but whether this is predominantly obstructive or central is unclear. This study aimed to estimate the prevalence of central sleep apnea (CSA) in tetraplegia and the contributions of central, obstructive, and hypopnea respiratory events to SDB summary indices in tetraplegia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Research and clinical data from 606 individuals with tetraplegia and full overnight polysomnography were collated. The proportions of different respiratory event types were calculated; overall and for mild, moderate, and severe disease. The prevalence of Predominant CSA (Central Apnea Index [CAI]\u2005\u2265\u20055 and more central than obstructive apneas) and Any CSA (CAI\u2005\u2265\u20055) was estimated. Prevalence of sleep-related hypoventilation (SRH) was estimated in a clinical sub-cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Respiratory events were primarily hypopneas (71%), followed by obstructive (23%), central (4%), and mixed apneas (2%). As severity increased, the relative contribution of hypopneas and central apneas decreased, while that of obstructive apneas increased. The prevalence of Predominant CSA and Any CSA were 4.3% (26\/606) and 8.4% (51\/606) respectively. Being male, on opiates and having a high tetraplegic spinal cord injury were associated with CSA. SRH was identified in 26% (26\/113) of the clinical sub-cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This is the largest study to characterize SDB in tetraplegia. It provides strong evidence that obstructive sleep apnea is the predominant SDB type; 9\u201318 times more prevalent than CSA. The prevalence of CSA was estimated to be 4%\u20138%, significantly lower than previously reported.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsad235","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T06:38:25Z","timestamp":1694414305000},"source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of central sleep apnea in people with tetraplegic spinal cord injury: a retrospective analysis of research and clinical data"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6048-0147","authenticated-orcid":false,"given":"Marnie","family":"Graco","sequence":"first","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Respiratory and Sleep Medicine, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Physiotherapy, University of Melbourne , Parkville, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren R","family":"Ruehland","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Respiratory and Sleep Medicine, Austin Health , Heidelberg, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Schembri","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health , Heidelberg, VIC , Australia"},{"name":"Clinical Epidemiology and Biostatistics Unit, Murdoch Children\u2019s Research Institute , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Churchward","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Respiratory and Sleep Medicine, Austin Health , Heidelberg, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krisha","family":"Saravanan","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Respiratory and Sleep Medicine, Austin Health , Heidelberg, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1847-4266","authenticated-orcid":false,"given":"Nicole L","family":"Sheers","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Respiratory and Sleep Medicine, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Physiotherapy, University of Melbourne , Parkville, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Berlowitz","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Respiratory and Sleep Medicine, Austin Health , Heidelberg, VIC , Australia"},{"name":"Department of Physiotherapy, University of Melbourne , Parkville, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"issue":"7","key":"2023121103391581600_CIT0001","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.apmr.2012.02.016","article-title":"Relationships between objective sleep indices and symptoms in a community sample of people with tetraplegia","volume":"93","author":"Berlowitz","year":"2012","journal-title":"Arch Phys Med Rehabil."},{"issue":"9","key":"2023121103391581600_CIT0002","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1136\/thoraxjnl-2017-211131","article-title":"Diagnostic accuracy of a two-stage model for detecting obstructive sleep apnoea in chronic 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