Risk of sleep apnea increases with increased severity of PTSD

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There is some bad news for those suffering from post-traumatic stress disorder (PTSD) symptoms specifically war veterans as according to a new study, the risk of obstructive sleep apnea (OSA) increases with increasing severity of PTSD.

The findings of the study are based on evaluations of 195 Iraq and Afghanistan US veterans who visited a VA outpatient PTSD clinic. Out of the 195 participants, ninety-three per cent were men, and their mean age was 33 years. Sleep apnea risk was evaluated using the Berlin Questionnaire, and PTSD was assessed using the PTSD Checklist Stressor Specific Version (PCL-S) questionnaire. Analyses controlled for potential confounders such as older age, smoking status, and use of central nervous system depressants.

Results reveal that nearly seven in 10 participants had a high risk for sleep apnea, and this risk increased with increase in severity of PTSD symptoms. The study, which is published in Journal of Clinical Sleep Medicine, also found that every clinically significant increase in PTSD symptom severity was associated with a 40 per cent increase in the probability of screening as high risk for sleep apnea.

Researchers revealed that younger veterans with PTSD are rarely screened for sleep apnea and frequently remain undiagnosed. They noted that the mechanism underlying the relationship between sleep apnea and PTSD in military veterans is unclear.

However, potential factors that may connect the two disorders include disturbed sleep in combat, prolonged sleep deprivation, sleep fragmentation and hyperarousal due to the physical and psychological stressors of combat, the chronic stress from PTSD, or the sleep disturbances caused by OSA. Longitudinal studies are needed to examine the temporal relationship between sleep apnea and PTSD.

Sonya Norman, PhD, researcher at the San Diego VA, and director of the PTSD Consultation Program at the National Center for PTSD, said that the findings are critical because sleep apnea is a risk factor for a long list of health problems including hypertension, cardiovascular disease and diabetes, and psychological problems such as depression, worsening PTSD and anxiety.

Owing to the long list of health problems for which sleep apnea is considered a risk factor, the American Academy of Sleep Medicine reports that this condition is a common sleep disease affecting at least 25 million in the US alone.

Some of the early warning signs of sleep apnea including snoring and choking, gasping or silent breathing pauses during sleep.