Sleep apnoea related hypoxia is associated with cognitive disturbances in patients with tetraplegia

Dimitar Sajkov, Ruth Marshall, Pieter Walker, Ivanka Mykytyn, R. Douglas McEvoy, Jo Wale, Howard Flavell, Andrew T. Thornton, Ral Antic

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)


Sleep disordered breathing is common in patients with tetraplegia. Nocturnal arterial hypoxemia and sleep fragmentation due to sleep apnoea may be associated with cognitive dysfunction. We therefore studied the influence of sleep disordered breathing on neuropsychological function in 37 representative tetraplegic patients (mean age 34 ± 9.7 years). Thirty percent (11 of 37 patients) had clinically significant sleep disordered breathing, defined as apnoea plus hypopnoea index (AHI) greater than 15 per hour of sleep. Most apnoeas were obstructive in type. Seven patients (19%) desaturated to < 80% during the night. Neuropsychological variables were significantly correlated with measures of sleep hypoxia, but not with the AHI and the frequency of sleep arousals. The neuropsychological functions most affected by nocturnal desaturation were: verbal attention and concentration, immediate and short-term memory, cognitive flexibility, internal scanning and working memory. There appeared to be a weak association between the presence of severe sleep hypoxia and visual perception, attention and concentration but no association was found between sleep variables and depression scores. We concluded that sleep disordered breathing is common in patients with tetraplegia and may be accompanied with significant oxygen desaturation. The latter impairs daytime cognitive function in these patients, particularly attention, concentration, memory and learning skills. Cognitive disturbances resulting from sleep apnoea might adversely affect rehabilitation in patients with tetraplegia.

Original languageEnglish
Pages (from-to)231-239
Number of pages9
JournalSpinal Cord
Issue number4
Publication statusPublished - 30 Mar 1998
Externally publishedYes


  • Cognitive impairment
  • Hypoxia
  • Sleep apnoea
  • Tetraplegia


Dive into the research topics of 'Sleep apnoea related hypoxia is associated with cognitive disturbances in patients with tetraplegia'. Together they form a unique fingerprint.

Cite this