Sleep-disordered breathing in patients with post-traumatic stress disorder

Ann Am Thorac Soc. 2015 Feb;12(2):259-68. doi: 10.1513/AnnalsATS.201407-299FR.

Abstract

Post-traumatic stress disorder (PTSD) and sleep-disordered breathing (SDB) are shared by many patients. They both affect sleep and the quality of life of affected subjects. A critical review of the literature supports an association between the two disorders in both combat-related and non-combat-related PTSD. The exact mechanism linking PTSD and SDB is not fully understood. A complex interplay between sleep fragmentation and neuroendocrine pathways is suggested. The overlap of symptoms between PTSD and SDB raises diagnostic challenges that may require a novel approach in the methods used to diagnose the coexisting disorders. Similar therapeutic challenges face patients and providers when treating concomitant PTSD and SDB. Although continuous positive airway pressure therapy imparts a mitigating effect on PTSD symptomatology, lack of both acceptance and adherence are common. Future research should focus on ways to improve adherence to continuous positive airway pressure therapy and on the use of alternative therapeutic methods for treating SDB in patients with PTSD.

Keywords: obstructive sleep apnea; post-traumatic stress disorder; sleep-disordered breathing; treatment.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Continuous Positive Airway Pressure
  • Humans
  • Patient Acceptance of Health Care
  • Patient Compliance
  • Sleep Apnea Syndromes / epidemiology
  • Sleep Apnea Syndromes / physiopathology
  • Sleep Apnea Syndromes / therapy
  • Sleep Apnea, Obstructive / epidemiology*
  • Sleep Apnea, Obstructive / physiopathology
  • Sleep Apnea, Obstructive / therapy
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Initiation and Maintenance Disorders / physiopathology
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / physiopathology