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Sleep and Breathing
Published in: Sleep and Breathing 1/2015

01-03-2015 | Original Article

Sleep disorders in combat-related PTSD

Authors: Scott G. Williams, Jacob Collen, Nicholas Orr, Aaron B. Holley, Christopher J. Lettieri

Published in: Sleep and Breathing | Issue 1/2015

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Abstract

Purpose

We sought to assess the rate of sleep complaints and sleep disorders among active duty soldiers with deployment-related PTSD and to determine whether any clinical features differentiated those with sleep disorders.

Methods

Retrospective review of consecutive soldiers diagnosed with PTSD. We recorded subjective measures of sleep and polysomnographic data. We compared clinical and demographic variables including psychoactive medication use, psychiatric comorbidity, and combat-related traumatic injury with the presence of sleep disorders.

Results

One hundred thirty patients were included (91.5 % male, mean age of 35.1 ± 10.6 years, mean body mass index (BMI) 28.9 ± 4.4 Kg/m2). About 88.5 % had comorbid depression, with the majority (96.2 %) taking psychoactive medications (mean 3.4 ± 1.6 medications per patient). Over half of the cohort suffered combat-related traumatic physical injuries (54.6 %). The obstructive sleep apnea syndrome (OSAS) was diagnosed in 67.3 % (80 % of the cohort underwent polysomnography), with a mean apnea hypopnea index of 24.1 ± 22.8 events/hour and a mean oxygen saturation nadir of 84.2 ± 5.7 %. OSAS was significantly more common in the non-injured soldiers (72.9 vs. 38.0 %, p < 0.001). In multivariate analysis, absence of physical injury showed a trend towards predicting OSAS.

Conclusions

Sleep complaints are common among soldiers with PTSD. We observed significantly higher rates of OSAS among those without physical injuries, raising the possibility that underlying sleep-disordered breathing is a risk factor for the development of PTSD. This potential association requires further validation.
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Metadata
Title
Sleep disorders in combat-related PTSD
Authors
Scott G. Williams
Jacob Collen
Nicholas Orr
Aaron B. Holley
Christopher J. Lettieri
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Sleep and Breathing / Issue 1/2015
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-014-0984-y

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