Spinal Cord Injury Network PhD scholarship announced…

Release date: 14-Feb-2014

Organisation: The Spinal Cord Injury Network, Sydney, NSW

The Spinal Cord Injury Network is pleased to announce that Marnie Graco based at the Institute for Breathing and Sleep at Austin Health has been awarded the Network’s inaugural PhD Scholarship. Marnie’s project “Towards better management of obstructive sleep apnoea in acute tetraplegia” aims to improve sleep, and therefore the quality of life of people with spinal cord injury. Up to 83% of people with acute tetraplegia have obstructive sleep apnoea (OSA) which has been linked to; poor health, problems with memory, learning and concentration.

Marnie’s research aims to understand the issues that are faced by patients, clinicians and hospitals in managing obstructive sleep apnoea. By understanding the experience of identifying and treating obstructive sleep apnoea in spinal units, Marnie and colleagues hope to develop and test practical solutions to commonly encountered problems. This will make it easier for spinal units around the world to change current practice and adopt evidence-based guidelines.

Marnie currently works at the Institute for Breathing and Sleep as Program Manager of the Sleep Health in Quadriplegia research program. This program was funded by the Transport Accident Commission in 2009 to address how the sleep of people with tetraplegia can be assessed, managed and improved.

The largest of the Sleep Health in Quadriplegia projects is a trial of continuous positive airway pressure (CPAP) for obstructive sleep apnoea in acute tetraplegia, and its effect on memory and learning. This trial has been implemented in 11 sites in Australia, New Zealand, Canada and the UK, and is almost two thirds completed. At the end of the trial the investigators hope to have a clear understanding of whether routinely screening for obstructive sleep apnoea and prescribing continuous positive airway pressure for three months in acute tetraplegia leads to better outcomes. Whilst this will be important information clinically, on its own it will not be enough to enable practice change interventions to be developed and tested.

Given the complexity of implementing continuous positive airway pressure for people with spinal cord injury, changing clinical practice globally will require additional information and support beyond the results of this trial. Marnie and her supervisors, Dr. David Berlowitz (from the Institute for Breathing and Sleep) and Professor Sally Green (from Monash University), will undertake a more detailed investigation of the experiences of obstructive sleep apnoea management at the level of the patient, clinician and spinal unit in order to complement and build on knowledge gained from other research.

Using this information, Marnie and colleagues plan to design and test a new model for detecting OSA in acute tetraplegia. Current guidelines recommend that clinicians perform a full sleep study (polysomnography) on all people with tetraplegia and symptoms of obstructive sleep apnoea. Polysomnography involves taking a comprehensive recording of the many physiological changes that occur during a person’s sleep. However, very few spinal units have access to this equipment or expertise. It is expensive and highly specialised equipment, which typically requires a sleep scientist to perform the test and a sleep physician to analyse and report the results.

One of the components of Marnie’s PhD involves developing a more practical approach to detecting obstructive sleep apnoea in acute tetraplegia. If successful, a simple screening tool that accurately detects obstructive sleep apnoea in the acute setting could replace the requirement for full polysomnography.

Go Back