The effects of nasal decongestion on obstructive sleep apnoea severity in people with tetraplegia

INTERVENTION: Single dose only of 0.5ml of 0.5% nasal phenyepherine spray delivered immediately prior to sleep. Intervention order will be randomised and there will be a one‐week washout period between treatments. CONDITION: Obstructive sleep apnoea Tetraplegia PRIMARY OUTCOME: The difference between the two treatment arms in the apnoea hypopnoea index (events per hour) obtained during the first 50% of the study nights. SECONDARY OUTCOME: Difference in nasal resistance as assessed using nasal rhinometry ; ; Difference in sleep quality as defined by the Arousal Index per hour of sleep in the first 50% of the study nights. ; Difference in subjective rating of nasal congestion (Modified Borg Congestion scale & Nasal Congestion Questionnaire) ; Difference in the route of breathing (proportion of the respiratory events that are identified as being through the nasal versus oral route as assessed using nasal pressure and thermistor) ; The difference between the two treatment arms in the 4% desaturation rate as assessed using pulse oximetry (events per hour) obtained during the entire study nights. The difference between the two treatment arms in the total apnoea hypopnoea index (events per hour) obtained during the study nights. ; ; INCLUSION CRITERIA: Tetraplegia obstructive sleep apnoea as defined as having an apnoea hypopnoea index of greater than 10 events per hour