A recent study found that those with posttraumatic stress disorder had significantly higher rates of obstructive sleep apnea, even after accounting for other risk factors.
The cross-sectional study, published in JAMA Network Open, investigated the relationship between PTSD and OSA using a population consisting of older male twin pairs who had served in the Vietnam war.
The study included 181 male twins with an average age of 68.4 years, consisting of 66 pairs with differing PTSD symptoms and 15 pairs with differing current PTSD diagnoses, who underwent in-laboratory polysomnography from March 20, 2017, to June 3, 2019. PTSD symptoms were assessed using the PTSD Checklist (PCL) and structured clinical interviews. Researchers controlled for demographics, behavioral factors, cardiovascular risk, and familial influences.
In the study sample, 74% of the men had at least mild OSA (apnea-hypopnea index [AHI] ≥5), 40% had moderate-to-severe OSA (AHI ≥15), and 18% had severe OSA (AHI ≥30).
Current PTSD symptoms and diagnoses were independently associated with OSA, with each 15-point increase in the PCL score linked to a 4.6 events-per-hour increase in AHI (95% confidence interval [CI] = 0.1-9.1).
A current PTSD diagnosis was associated with an adjusted 10.5 events-per-hour higher AHI compared with those without PTSD (95% CI = 5.7-15.3).
The standardized association between PTSD symptoms and AHI per standard deviation increase (1.9 events per hour; 95% CI = 0.5-3.3 events per hour) was comparable to that of body mass index, a recognized risk factor for OSA.
The study authors concluded, "In this cross-sectional study of veteran twins, we found a strong dose-response association between PTSD and OSA. ...More research is needed to examine possible biobehavioral and psychophysiologic interventions that could ameliorate both sleep-disordered breathing and PTSD."
This research was supported by grants from the National Institutes of Health, and the authors reported no conflicts of interest related to this study.