# TOWARDS AN UNDERSTANDING OF DISTURBED SLEEP PHENOTYPES AFTER TRAUMATIC SPINAL CORD INJURY

## TL;DR

This study found that sleep disorders like sleep apnoea and insomnia are common in Veterans with spinal cord injuries and are linked to heart and metabolic health issues.

## Contribution

The study identifies two distinct sleep-related health clusters in spinal cord injury patients using data-driven analysis.

## Key findings

- Sleep apnoea and insomnia were the most common sleep diagnoses in the study population.
- Two distinct sleep clusters were identified, each associated with specific cardiometabolic and psychological conditions.
- Sleep disorders were found to be closely linked to cardiovascular health in individuals with spinal cord injuries.

## Abstract

Examine the Spinal Cord Injury-Pressure Injury Resource (SCI-PIR) database to assess the prevalence and identify relationships among sleep disorders and cardiometabolic risk after spinal cord injury.

Retrospective observational cohort study using the Department of Veterans Affair SCI-PIR database.

18,894 Veterans living with spinal cord injury.

The SCI-PIR database was queried for ICD9 codes related to cardiovascular, metabolic, psychological, and sleep conditions to identify subgroups of spinal cord injury individuals with sleep disorders and associated clustering of cardiometabolic risk factors and sleep diagnoses. Multiple correspondence analysis probed the underlying associations. Cramer V statistics confirmed and quantified the associations.

Sleep apnoea (6.7%) and insomnia (4.3%) were the most common sleep diagnoses. Multiple correspondence analysis demonstrated 2 phenotypic clusters: Cluster A showed robust links between sleep apnoea, hypersomnia, heart failure, and arrhythmias, and secondary associations with coronary artery disease, chronic kidney disease, obesity, diabetes, and hyperlipidaemia. Cluster B showed strong relationships between insomnia, anxiety, and post-traumatic stress disorder.

2 distinct sleep clusters were identified for persons with spinal cord injury. This analysis supports previous findings that sleep disorders associate with overall health in individuals with spinal cord injury, and particularly cardiovascular health. ICD9 coding may under-report sleep diagnoses. Data-driven statistical analysis can uncover insights into the complex interplay between spinal cord injury and secondary health conditions.

This study looked at how sleep problems relate to heart and metabolic health in Veterans with spinal cord injuries. Using a large database from the Department of Veterans Affairs, researchers analysed health records of nearly 19,000 Veterans with spinal cord injuries. We found that sleep apnoea and insomnia were the most common sleep issues. Two distinct groups emerged: 1 linked sleep apnoea and excessive sleepiness with heart failure and irregular heartbeats, along with other conditions like diabetes and obesity. The other group showed a strong connection between insomnia, anxiety, and post-traumatic stress disorder. These findings suggest that sleep problems in people with spinal cord injuries are closely tied to overall health, especially heart health. The study also highlights that sleep issues may be underdiagnosed, and that using data-driven methods can help uncover important health patterns.