SESSION TITLE: Sleep Disorders II
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Wednesday, October 30, 2013 at 02:45 PM - 04:15 PM
PURPOSE: Military personnel are diagnosed with the service-related illnesses of depression, traumatic brain injury (TBI), pain and post-traumatic stress disorder (PTSD). These illnesses are associated with obstructive sleep apnea (OSA). OSA results in cognitive impairment and low levels of IGF-1. IGF-1 regulates glucose utilization in the brain and has a role in dendritic growth. Treatment of OSA with continuous positive airway pressure (CPAP) improves the physiologic derangements of OSA, improves sleep quality and cognitive function. We assessed changes in sleep, service-related illnesses and IGF-1 levels in relation to CPAP compliance.
METHODS: Military personnel diagnosed with OSA underwent baseline and follow-up assessments at 90 days with validated questionnaires for depression, TBI, pain, PTSD, sleep and blood draws for IGF-1. Participants received standard clinical care with CPAP with compliance assessed by CPAP download at 30 days post-treatment. They were classified as compliant if they used CPAP > 4 hours/night 70% of nights. IGF-1 concentrations were determined by a commercially available kit that was reliable and valid.
RESULTS: There were 59 participants, all males, mean age 35.9±7.8, BMI 31.4±3.7, AHI 19.1±19.0, ESS 13.8±5.3. The most frequent comorbid illnesses were insomnia in 64.4% and depression in 50.8%. There were no clinical differences between the CPAP compliant and non-compliant groups. CPAP compliance was achieved in 23 (39%); their usage of 5.9±0.8 hours was elevated compared to non-compliant patients at 2.4±2.1 hours (p= 0.001). Compliance was associated with improvements in sleepiness (p=0.001), sleep quality (p<0.01), depression (p<0.05) and fatigue (p<0.05). IGF-1 levels did not differ at baseline between compliant and non-compliant patients; however, compliance resulted in a significant increase in IGF-1 (p< 0.01).
CONCLUSIONS: Military personnel with OSA and service-related illnesses who are compliant with CPAP have improved sleep, fatigue and depressive symptoms as well as increases in IGF-1.
CLINICAL IMPLICATIONS: The diagnosis and treatment of OSA in military personnel may help to alleviate symptoms of service-related illnesses. IGF-1 is a potential biomarker of adequate treatment of OSA.
DISCLOSURE: The following authors have nothing to disclose: Vincent Mysliwiec, Jessica Gill, Hyunhwa Lee, Tristin Baxter, Morgan Heinzelmann, Taura Barr, Bernard Roth
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