{"doi":"10.1093/sleep/zsae044","title":"Intensive support does not improve positive-airway pressure use in spinal cord injury/disease: a randomized clinical trial","abstract":"STUDY OBJECTIVE: Treatment of sleep-disordered breathing (SDB) with positive airway pressure (PAP) therapy has unique clinical challenges in individuals living with spinal cord injuries and diseases (spinal cord injury [SCI]/D). Interventions focused on increasing PAP use have not been studied in this population. We aimed to evaluate the benefits of a program to increase PAP use among Veterans with SCI/D and SDB. METHODS: Randomized controlled trial comparing a behavioral Intervention (n = 32) and educational control (n = 31), both including one face-to-face and five telephone sessions over 3 months. The intervention included education about SDB and PAP, goal setting, troubleshooting, and motivational enhancement. The control arm included non-directive sleep education only. RESULTS: Primary outcomes were objective PAP use (nights ≥4 hours used within 90 days) and sleep quality (Pittsburgh Sleep Quality Index [PSQI] at 3 months). These did not differ between intervention and control (main outcome timepoint; mean difference 3.5 [-9.0, 15.9] nights/week for PAP use; p = .578; -1.1 [-2.8, 0.6] points for PSQI; p = .219). Secondary outcomes included fatigue, depression, function, and quality of life. Only fatigue improved significantly more in the intervention versus the control group (p = .025). Across groups, more PAP use was associated with larger improvements in sleep quality, insomnia, sleepiness, fatigue, and depression at some time points. CONCLUSIONS: PAP use in Veterans with SCI/D and SDB is low, and a 3-month supportive/behavioral program did not show significant benefit compared to education alone. Overall, more PAP use was associated with improved symptoms suggesting more intensive support, such as in-home assistance, may be required to increase PAP use in these patients. CLINICAL TRIALS INFORMATION: Title: \"Treatment of Sleep Disordered Breathing in Patients with SCI.\" Registration number: NCT02830074. Website: https://clinicaltrials.gov/study/NCT02830074?cond=Sleep%20Apnea&term=badr&rank=5.","journal":"SLEEP","year":2024,"id":454172,"datarank":0.37638572989759256,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.06446949864561714,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.06446949864561714,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":5,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9535,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02830074"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":321251,"name":"Jennifer L. Martin","orcid":"0000-0003-0849-3391","position":1,"is_corresponding":false},{"id":423961,"name":"Abdulghani Sankari","orcid":"0000-0002-2400-3375","position":2,"is_corresponding":false},{"id":834389,"name":"Salam Zeineddine","orcid":null,"position":3,"is_corresponding":false},{"id":834390,"name":"Anan Salloum","orcid":null,"position":4,"is_corresponding":false},{"id":1277425,"name":"M. Kristi Henzel","orcid":"0000-0002-8382-574X","position":5,"is_corresponding":false},{"id":423974,"name":"Kingman P. Strohl","orcid":"0000-0001-7740-9013","position":6,"is_corresponding":false},{"id":1277804,"name":"Afifa Shamim-Uzzaman","orcid":null,"position":7,"is_corresponding":false},{"id":406912,"name":"Anna M. May","orcid":"0000-0002-0181-0086","position":8,"is_corresponding":false},{"id":321246,"name":"Constance H. Fung","orcid":"0000-0002-0140-7932","position":9,"is_corresponding":false},{"id":951611,"name":"Nishtha Pandya","orcid":null,"position":10,"is_corresponding":false},{"id":834202,"name":"Sean Carroll","orcid":"0000-0003-3796-448X","position":11,"is_corresponding":false},{"id":322169,"name":"Michael Mitchell","orcid":null,"position":12,"is_corresponding":false},{"id":420590,"name":"M. Safwan Badr","orcid":"0000-0001-5769-5243","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T02:03:07.923686Z","pmid":"38422375","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}