A prospective, randomised controlled trial of auto-titrating Continuous positive airway pressure treatment for Obstructive Sleep Apnoea after acute Quadriplegia

INTERVENTION: Three months of nightly, nocturnal continuous positive airway pressure and usual care. The devices are auto‐titrating, therefore the amount of pressure delivered is that which is sufficient to maintain a patent upper airway during sleep. Usual care is all other care provide to those with acute tetraplegia. This may include treatment for low lung volumes and retention of lung secretions. CONDITION: Acute tetraplegia Obstructive Sleep Apnoea PRIMARY OUTCOME: Neurocognitive performance SECONDARY OUTCOME: Anxiety and Depression. Hospital Depression and Anxiety Scale Daytime, state sleepiness; Karolinska Sleepiness Scale score Mood. Profile of Mood States Quality of Life. Measured with the Assessment of Quality of Life measure Respiratory function (spirometry) Sleepiness and sleep symptoms. Basic Nordic Sleep Questionnaire INCLUSION CRITERIA: Acute, traumatic quadriplegia. Obstructive Sleep Apnoea confirmed on full polysomnography. Able to tolerate at least four hours of CPAP use on at least one of first three nights on which the device is trialled.