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Pilot study assessing the impact of intrathecal baclofen administration mode on sleep-related respiratory parameters.
Arch Phys Med Rehabil 2012; 93(1):96-9AP

Abstract

OBJECTIVE

To assess the impact of intrathecal baclofen (ITB) mode of administration on sleep and sleep-related breathing events in severely disabled patients with severe spasticity.

DESIGN

Open prospective trial.

SETTING

Physical medicine and rehabilitation department.

PARTICIPANTS

Patients (N=11) treated with ITB pump for severe spasticity.

INTERVENTION

Assessment of patients' sleep before and after ITB pump implantation, and comparison of polysomnography results after continuous or bolus mode of administration of ITB.

MAIN OUTCOME MEASURES

Polysomnography and sleep-related breathing events.

RESULTS

ITB reduced periodic limb movements and increased the respiratory disturbance index (RDI) and central apneas in our population of patients. This study showed that ITB mode of administration may affect sleep-disordered breathing. Indeed, we observed a significant increase of respiratory events in the bolus condition (RDI and central apneas). In contrast, continuous infusion did not induce a significant modification of sleep-disordered breathing. When a sleep apnea syndrome was preexisting, it was generally severely worsened by the bolus mode of administration.

CONCLUSIONS

These results indicate that sleep function and sleep-related respiratory events should be assessed before ITB pump implantation. It is probably better to use a continuous mode of infusion if patients have preexisting sleep-disordered breathing.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, R. Poincaré Hospital, AP-HP, University of Versailles Saint Quentin, Garches, France. djamel.bensmail@rpc.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

22200387

Citation

Bensmail, Djamel, et al. "Pilot Study Assessing the Impact of Intrathecal Baclofen Administration Mode On Sleep-related Respiratory Parameters." Archives of Physical Medicine and Rehabilitation, vol. 93, no. 1, 2012, pp. 96-9.
Bensmail D, Marquer A, Roche N, et al. Pilot study assessing the impact of intrathecal baclofen administration mode on sleep-related respiratory parameters. Arch Phys Med Rehabil. 2012;93(1):96-9.
Bensmail, D., Marquer, A., Roche, N., Godard, A. L., Lofaso, F., & Quera-Salva, M. A. (2012). Pilot study assessing the impact of intrathecal baclofen administration mode on sleep-related respiratory parameters. Archives of Physical Medicine and Rehabilitation, 93(1), pp. 96-9. doi:10.1016/j.apmr.2011.08.020.
Bensmail D, et al. Pilot Study Assessing the Impact of Intrathecal Baclofen Administration Mode On Sleep-related Respiratory Parameters. Arch Phys Med Rehabil. 2012;93(1):96-9. PubMed PMID: 22200387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pilot study assessing the impact of intrathecal baclofen administration mode on sleep-related respiratory parameters. AU - Bensmail,Djamel, AU - Marquer,Adélaïde, AU - Roche,Nicolas, AU - Godard,Anne-Laure, AU - Lofaso,Frédéric, AU - Quera-Salva,Maria-Antonia, PY - 2011/03/16/received PY - 2011/08/19/revised PY - 2011/08/20/accepted PY - 2011/12/28/entrez PY - 2011/12/28/pubmed PY - 2012/2/18/medline SP - 96 EP - 9 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 93 IS - 1 N2 - OBJECTIVE: To assess the impact of intrathecal baclofen (ITB) mode of administration on sleep and sleep-related breathing events in severely disabled patients with severe spasticity. DESIGN: Open prospective trial. SETTING: Physical medicine and rehabilitation department. PARTICIPANTS: Patients (N=11) treated with ITB pump for severe spasticity. INTERVENTION: Assessment of patients' sleep before and after ITB pump implantation, and comparison of polysomnography results after continuous or bolus mode of administration of ITB. MAIN OUTCOME MEASURES: Polysomnography and sleep-related breathing events. RESULTS: ITB reduced periodic limb movements and increased the respiratory disturbance index (RDI) and central apneas in our population of patients. This study showed that ITB mode of administration may affect sleep-disordered breathing. Indeed, we observed a significant increase of respiratory events in the bolus condition (RDI and central apneas). In contrast, continuous infusion did not induce a significant modification of sleep-disordered breathing. When a sleep apnea syndrome was preexisting, it was generally severely worsened by the bolus mode of administration. CONCLUSIONS: These results indicate that sleep function and sleep-related respiratory events should be assessed before ITB pump implantation. It is probably better to use a continuous mode of infusion if patients have preexisting sleep-disordered breathing. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/22200387/Pilot_study_assessing_the_impact_of_intrathecal_baclofen_administration_mode_on_sleep_related_respiratory_parameters_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(11)00717-9 DB - PRIME DP - Unbound Medicine ER -