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Updated: Jan 4, 2026
A Murine Model of Cervical Spinal Cord Injury to Study Post-lesional Respiratory Neuroplasticity
Published on: May 28, 2014
Sleep-disordered breathing is associated with brain vascular reactivity in spinal cord injury
Jordan W Squair1, Amanda H X Lee1, Zoe K Sarafis1
1From the Departments of Physiology and Pharmacology, Clinical Neurosciences, and Cardiac Sciences (J.W.S., A.A.P.), and Hotchkiss Brain Institute, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine (J.W.S., A.A.P.), University of Calgary; Centre for Heart, Lung and Vascular Health, Faculty of Health and Social Development (G.C.), University of British Columbia Okanagan, Kelowna; International Collaboration on Repair Discoveries (ICORD) (J.W.S., A.H.X.L., Z.K.S., J.J.C., A.V.K.), MD/PhD Training Program (J.W.S.), and Department of Experimental Medicine (J.W.S., A.H.X.L.), Faculty of Medicine, and Faculty of Pharmaceutical Sciences (J.J.C.), University of British Columbia, Vancouver, Canada; Department of Integrative Physiology (O.B., T.M., Z.D.) and Department of Neuroscience, Split Sleep Medicine Center (R.P., Z.D.), University of Split School of Medicine, Split, Croatia; and Department of Physiology (O.B.), University of Novi Sad Medical School, Serbia.
Objective:
To determine the population-level odds of individuals with spinal cord injury (SCI) experiencing fatigue and sleep apnea, to elucidate relationships with level and severity of injury, and to examine associations with abnormal cerebrovascular responsiveness.
Methods:
We used population-level data, meta-analyses, and primary physiologic assessments to provide a large-scale integrated assessment of sleep-related complications after SCI. Population-level and meta-analyses included more than 60,000 able-bodied individuals and more than 1,800 individuals with SCI. Physiologic assessments were completed on a homogenous sample of individuals with cervical SCI and matched controls. We examined the prevalence of (1) self-reported chronic fatigue, (2) clinically identified sleep apnea, and 3) cerebrovascular responsiveness to changing CO2.
Results:
Logistic regression revealed a 7-fold elevated odds of chronic fatigue after SCI (odds ratio [OR] 7.9, 95% confidence interval [CI] 3.5-16.2), and that fatigue and trouble sleeping are correlated with the level and severity of injury. We further show that those with SCI experience elevated risk of clinically defined sleep-disordered breathing in more than 600 individuals with SCI (pooled OR 3.1, 95% CI 1.3-7.5). We confirmed that individuals with SCI experience a high rate of clinically defined sleep apnea using primary polysomnography assessments. We then provide evidence using syndromic analysis that sleep-disordered breathing is a factor strongly associated with impaired cerebrovascular responsiveness to CO2 in patients with SCI.
Conclusions:
Individuals with SCI have an increased prevalence of sleep-disordered breathing, which may partially underpin their increased risk of stroke. There is thus a need to integrate sleep-related breathing examinations into routine care for individuals with SCI.
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