Obstructive Sleep Apnea and Posttraumatic Stress Disorder among OEF/OIF/OND Veterans

J Clin Sleep Med. 2015 Apr 15;11(5):513-8. doi: 10.5664/jcsm.4692.

Abstract

Objectives: This study examined: (a) the relationship between self-reported posttraumatic stress disorder (PTSD) symptoms and risk of obstructive sleep apnea (OSA) in a younger, Iraq and Afghanistan (OEF/OIF/OND) veteran sample seeking treatment for PTSD; and (b) the relationships between PTSD symptom scores and each risk factor of OSA (snoring, fatigue, high blood pressure/BMI).

Methods: Participants were 195 Iraq and Afghanistan veterans presenting to a VA outpatient PTSD clinic for evaluation. Veterans were 21 to 59 years old (mean 33.40, SD 8.35) and 93.3% male (n = 182). Logistic regressions were run to examine whether veterans with greater PTSD symptom severity had an increased probability of screening as high risk for OSA, even after controlling for known risk factors (older age, positive smoking status, and use of CNS depressants).

Results: Of 159 veterans screened, 69.2% were assessed as being at high risk for OSA. PTSD symptom severity increased the risk of screening positive for OSA. PTSD symptom severity increased risk of screening positive for snoring and fatigue, but not high blood pressure/BMI.

Conclusions: OEF/OIF/OND veterans with PTSD screen as high risk for OSA at much higher rates than those seen in community studies and may not show all classic predictors of OSA (i.e., older and higher BMI). This study is the first to suggest that the Berlin may be a useful screener for OSA in a younger OEF/OIF/OND veteran population with PTSD. Screening of younger veterans with PTSD for OSA should be standard care, and polysomnography and OSA interventions should be readily available to younger veterans.

Keywords: OEF/OIF/OND; PTSD; obstructive sleep apnea; veterans.

MeSH terms

  • Adult
  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Iraq War, 2003-2011*
  • Male
  • Middle Aged
  • Polysomnography / statistics & numerical data
  • Risk Factors
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / epidemiology*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • United States / epidemiology
  • Veterans / statistics & numerical data*
  • Young Adult