Indian Journal of Sleep Medicine

Register      Login

VOLUME 12 , ISSUE 1 ( January-March, 2017 ) > List of Articles

ORIGINAL ARTICLE

A Comparison of Sleep Apnea Syndrome in Military Veterans with Control Group

Fariborz Rezaeitalab, Amir Rezaei Ardani, Yalda Ravanshad, Mohammad Reza Sobhani, Saeidehanvari

Citation Information : Rezaeitalab F, Ardani AR, Ravanshad Y, Sobhani MR, S. A Comparison of Sleep Apnea Syndrome in Military Veterans with Control Group. Indian Sleep Med 2017; 12 (1):29-34.

DOI: 10.5958/0974-0155.2017.00005.5

License: NA

Published Online: 01-12-2014

Copyright Statement:  NA


Abstract

Introduction: Sleep is frequently complicated in military veterans with post-traumatic stress disorder (PTSD). Obstructive sleep apnea (OSA), a common sleep disordered breathing which affects mostly middle aged men, may be an important reason for sleep disturbances symptoms in military veterans. This study was conducted to compare the clinical features and polysomnographic parameters of OSA in PTSD veterans and control group. Materials: 26 PTSD veterans diagnosed with OSA by standard polysomnography were studied. Body mass index (BMI) was recorded and Epworth Sleepiness Scale, a questionnaire for evaluation of daytime sleepiness was applied. The control group was consisting of men matched for age who diagnosed also with OSA. Results: The mean age of veterans was 53.73 ± 8.7, and of the control group was 52.11 ± 6.2 years. The most common initial complaint in veterans was insomnia (57.5%) following by aggressiveness (14.5%), while non-veterans mostly complained from snoring (53.8%) and sleepiness (23%). Apnea-hypopnea index (AHI) was on average 38.8 ± 27.2. Mean BMI of veterans was 28.5 ± 5.7 and it was not related with AHI. Conclusions: Unlike most of patients with sleep apnea, veterans mainly complain of insomnia and aggression. Moreover, BMI cannot predict the severity of sleep apnea in such patients. Therefore, it is recommended that veterans should be carefully investigated for OSA, even in the absence of typical presentation of OSA.


PDF Share
  1. Krishnan LL, Petersen NJ, Snow AL, Cully JA, Schulz PE, Graham DP, et al. Prevalence of dementia among Veterans Affairs medical care system users. Dementia and geriatric cognitive disorders. 2005;20(4):245-53.
  2. Yesavage JA, Kinoshita LM, Kimball T, Zeitzer J, Friedman L, Noda A, et al. Sleep-disordered breathing in Vietnam veterans with posttraumatic stress disorder. The American Journal of Geriatric Psychiatry. 2012;20(3):199- 204.
  3. Youakim JM, Doghramji K, Schutte SL. Posttraumatic stress disorder and obstructive sleep apnea syndrome. Psychosomatics. 1998;39(2):168-71.
  4. Levrier K, Marchand A, Belleville G, Dominic B-P, Guay S. Nightmare Frequency, Nightmare Distress and the Efficiency of Trauma-Focused Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder. Archives of Trauma Research. 2016(In Press).
  5. Vieweg W, Julius DA, Fernandez A, Tassone DM, Narla SN, Pandurangi A. Posttraumatic stress disorder in male military veterans with comorbid overweight and obesity: psychotropic, antihypertensive, and metabolic medications. Prim Care Companion J Clin Psychiatry. 2006;8(1):25- 31.
  6. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, et al. The development of a clinician-administered PTSD scale. Journal of traumatic stress. 1995;8(1):75-90.
  7. Kibler JL, Joshi K, Ma M. Hypertension in relation to posttraumatic stress disorder and depression in the US National Comorbidity Survey. Behavioral Medicine. 2009;34(4):125-32.
  8. Knopman D, Boland L, Mosley T, Howard G, Liao D, Szklo M, et al. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology. 2001;56(1):42- 8.
  9. Forbus L, Kelly UA. Screening for Obstructive Sleep Apnea in Veterans Seeking Treatment of Posttraumatic Stress Disorder. Advances in Nursing Science. 2015;38(4):298- 305.
  10. Colvonen PJ, Masino T, Drummond S, Myers US, Angkaw AC, Norman SB. Obstructive Sleep Apnea and Posttraumatic Stress Disorder among OEF/OIF/OND Veterans. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine. 2015;11(5):513-8.
  11. Ocasio-Tascón ME, Alicea-Colón E, Torres-Palacios A, Rodríguez-Cintrón W. The veteran population: one at high risk for sleep-disordered breathing. Sleep and Breathing. 2006;10(2):70-5.
  12. Fishman AP, Elias JA, Grripi MA, Senior RM, Pack AI. 4th ed. USA: McGraw-Hill; 2008. Fishman's pulmonary diseases and disorders.
  13. Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Jama. 2000;283(14):1829-36.
  14. Ayas N, Gershon A, Tomlinson G, Leung R, Kendzerska T. The Interaction Of Obesity And Nocturnal Hypoxemia On Cardio-Vascular Consequences In Adults With Obstructive Sleep Apnea: A Historical Observational Study. Institute for Clinical Evaluative Sciences. 2016;2(1):3.
  15. Ortega FB, Lavie CJ, Blair SN. Obesity and cardiovascular disease. Circulation research. 2016;118(11):1752-70.
  16. Hrubos-Strøm H, Nordhus IH, Einvik G, Randby A, Omland T, Sundet K, et al. Obstructive sleep apnea, verbal memory, and executive function in a community-based highrisk population identified by the Berlin Questionnaire Akershus Sleep Apnea Project. Sleep and Breathing. 2012;16(1):223-31.
  17. Torelli F, Moscufo N, Garreffa G, Placidi F, Romigi A, Zannino S, et al. Cognitive profile and brain morphological changes in obstructive sleep apnea. Neuroimage. 2011;54(2):787-93.
  18. Van Dongen H, Kerkhof G. Cognition and daytime functioning in sleep-related breathing disorders. Human Sleep and Cognition, Part II: Clinical and Applied Research. 2011;2:53.
  19. Rezaeitalab F, Moharrari F, Saberi S, Asadpour H, Rezaeetalab F. The correlation of anxiety and depression with obstructive sleep apnea syndrome. J Res Med Sci 2014; 19(3): 205-10.
  20. El-Solh AA, Ayyar L, Akinnusi M, Relia S, Akinnusi O. Positive airway pressure adherence in veterans with posttraumatic stress disorder. Sleep. 2010;33(11):1495- 500.
  21. Qureshi SU, Long ME, Bradshaw MR, Pyne JM, Magruder KM, Kimbrell T, et al. Does PTSD impair cognition beyond the effect of trauma? The Journal of neuropsychiatry and clinical neurosciences. 2011;23(1):16-28.
  22. American Academy of Sleep Medicine; International classifi cation of sleep disorders: Diagnostic and coding manual. 2nd ed. New York: Westchester, III; 2013.
  23. Haghighi KS, Montazeri A, Mehrizi AK, Aminian O, Golkhandan AR, Saraei M, et al. The Epworth Sleepiness Scale: translation and validation study of the Iranian version. Sleep and Breathing. 2013;17(1):419-26.
  24. Iber C. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications: American Academy of Sleep Medicine; 2014.
  25. Langton RS, Neyra J, Downs JW, Niebuhr DW. The relationship between enlistment body mass index and the development of obstructive sleep apnea in the US Military. Military medicine. 2016;181(8):913-9.
  26. Lettieri CJ, Eliasson AH, Andrada T, Khramtsov A, Raphaelson M, Kristo DA. Obstructive sleep apnea syndrome: are we missing an at-risk population? CHEST Journal. 2005;128(4_MeetingAbstracts):133S-b-S.
  27. Liempt S, Westenberg H, Arends J, Vermetten E. Obstructive sleep apnea in combat-related posttraumatic stress disorder: a controlled polysomnography study. 2011.
  28. Webber MP, Lee R, Soo J, Gustave J, Hall CB, Kelly K, et al. Prevalence and incidence of high risk for obstructive sleep apnea in World Trade Center-exposed rescue/recovery workers. Sleep and Breathing. 2011;15(3):283-94.
  29. De Groen J, Op den Velde W, Hovens J, Falger P. Snoring and anxiety dreams. Sleep: Journal of Sleep Research & Sleep Medicine. 1993.
  30. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. The Lancet. 2005;3 65(9464):1046-53.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.