PURPOSE: The purpose of our study is to determine how frequent sleep disordered breathing is among combat veterans with PTSD. Sleep disorders such as recurrent dreams, staying asleep or falling asleep are well known in patients with PTSD. OSA has not been well described as a salient feature of PTSD. There are some case reports showing significantly improved PTSD in patients in treated OSA.
METHODS: Sleep questionnaires were collected at random from the Sleep Clinic at Darnell Army Medical Center, Fort Hood, Texas from combat veterans deployed between MAR 2003 and JAN 2008. PTSD is a listed question. We retrospectively reviewed all the polysomongrams (PSG) results on each questionnaire that had PTSD checked to evaluate the outcome of sleep disorder breathing. Parameters for review included a diagnosis of post traumatic stress disorder (PTSD), body mass index, age, deployment history, Epworth Sleepiness Scale (ESS), number of psychotropic and sleep aide medications, and PSG results.
RESULTS: 167 questionnaires were reviewed with the diagnosis of PTSD: 98% were male, 31 (19%) failed to keep appointments for the PSG. Of the remaining 136 studies reviewed, 73% were positive for the diagnosis of obstructive sleep apnea. Average age for those diagnosed with sleep apnea was 34 (range 21-50), mean BMI 31 (range 20-38), and average ESS 14 (range 2-20). These data matched closely with those not diagnosed with OSA. Average age 32 (22-42), mean BMI 29 (21-37), average ESS11 (2-20). There was no difference noted in number of medications used.
CONCLUSION: In this interim study report, these data show that more than 70% of those active duty members who carry a diagnosis of PTSD are at risk for the diagnosis of OSA. There is no correlation for ESS, BMI or age between those who are diagnosed with both PTSD and OSA and those who are OSA free.
CLINICAL IMPLICATIONS: Combat Veterans with PTSD who suffer from difficulty with sleep should be considered for evaluation of sleep disordered breathing prior to additional treatment, including pharmacotherapy.
DISCLOSURE: Darrel Dodson, No Financial Disclosure Information; No Product/Research Disclosure Information