ptsd Chest: Apnea Elevated In Vets With Ptsd

[pacmanx1]

The rest of this article can be found on; http://www.medpageto....cfm?tbid=23074

MedPage Today Action Points

• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  
• Explain to interested patients that almost all combat veterans with post-traumatic stress disorder (PTSD) (98%) have a sleep disorder -- with more cases of sleep apnea than might otherwise be expected.
  
• Note that just more than half (54%) of these military PTSD patients were diagnosed with obstructive sleep apnea.

[mrs rockman (widow of vet)]

The rest of this article can be found on; http://www.medpageto....cfm?tbid=23074

MedPage Today Action Points

• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  
• Explain to interested patients that almost all combat veterans with post-traumatic stress disorder (PTSD) (98%) have a sleep disorder -- with more cases of sleep apnea than might otherwise be expected.
  
• Note that just more than half (54%) of these military PTSD patients were diagnosed with obstructive sleep apnea.
• For some reason, I cannot pull up the site.
• I just went to my cardiologist yesterday (Privare doc) and he was asking things like :
• Do I have leg cramps?
• Do I have swelling in my feet or ankles?
• My answer was yes to both.
• I have IHD and pulmonary fibrosis.
• He said that he may want me to do a sleep study. I just got thru filing for PTSD ( after trying to forget it for 38 years. I never had put the two together, but after reading this, I now want to know more.
• rockman

[71M10]

I am glad to see a "medical professional" begin to put this common sense into writing. They have for years noted that disrupted sleep is contibutory to developing OSA. Some studies have suggested that disrupted sleep screws up the balance of the hormones and peptides(? not sure if it is right word) which causes some people to begin gaining weight (influences saity/ hunger and metabolism), the weight gain pushes them into OSA, the OSA further excaberates the hormone problem, energy levels drop-activity drops, weight continues to build.....

I am pretty sure my OSA started in Korea. Never knew that those comfy quanset hut's with the deisel heaters, a 50 yard walk to the latrine in the middle of the night, and some of the hardest partying Artillerymen this side of Hell would have such a longterm effect. Unfortunately very few medical researchers would be allowed to publish a connection like that.

On The Minute!

Best regards,

Tyler

[pacmanx1]

For those who can not pull up the full article:

VANCOUVER -- Combat veterans with post-traumatic stress disorder (PTSD) almost universally suffer sleep problems -- with more cases of sleep apnea than might otherwise be expected -- U.S. Army researchers found.

In a group of 135 young, otherwise healthy combat veterans with PTSD, 98.5% reported sleep complaints, Nick Orr, MD, and colleagues at the Walter Reed Army Medical Center in Washington, D.C., reported here at the annual international scientific meeting of the American College of Chest Physicians (CHEST).

Despite their relatively young age (around 35) and slightly overweight physique, 54% of the PTSD patients who underwent polysomnography at Walter Reed were diagnosed with obstructive sleep apnea (OSA) -- whereas, in the general population, the rate of OSA is only 20%.

It can be all too easy to dismiss daytime sleepiness and other symptoms as part of depression and PTSD, Orr explained. But these results argue for screening all military PTSD patients for sleep apnea, Orr said in an interview.

"You'll be darned if you just keep treating it with medications, cognitive behavioral therapy, and all the other modalities you use for PTSD, when you haven't addressed possible sleep apnea, which could get restorative sleep and kind of break the cycle for the PTSD symptoms," he told MedPage Today.

Session co-moderator Andreea L. Antonescu-Turcu, MD, of the Medical College of Wisconsin and chief of pulmonology at the Zablocki VA Medical Center, both located in Milwaukee, agreed that the study results should justify the importance of screening for sleep problems in military patients with PTSD -- even when they don't fit the classical profile for OSA.

"As the data are coming out it probably should be part of their routine evaluations to screen for sleep disordered breathing," she told MedPage Today. "Maybe this is part of their disorder that we have to address early on in patients with PTSD."

The reason for the well-recognized sleep problems in PTSD isn't clear, but recent reports have argued that these symptoms should be considered a central feature of the disorder and not just a consequence of it, Orr noted.

His group retrospectively analyzed electronic medical records for all 135 service members (91.9% men, average age 35.3) with combat-related PTSD seen at the Walter Reed sleep clinic from March 2006 through April 2010.

Orr noted that these returning soldiers were assigned to the Warrior Transition Brigades, which were asked to refer PTSD cases with with traumatic brain injury to the sleep clinic.

Not surprisingly, the majority of veterans in the current study had been injured (80 of the 135) and about 70% were traumatic brain injuries, primarily mild concussions from blast incidents.

The average body mass index (BMI) was 28.91 -- putting most of the patients in the overweight but not obese category.

Comorbid psychiatric illness was nearly universal with PTSD in the study patients; 88.9% suffered from depression and 44.4% were diagnosed with anxiety.

Sleep complaints among the study patients included excessive daytime somnolence in 88.2% -- confirmed by an average Epworth Sleepiness Scale score in the "sleepy" range (10.7) -- as well as sleep fragmentation in 67.4% and difficulty falling asleep in 55.6%.

Polysomnography done in 80.7% of the study patients diagnosed insomnia in 55% and OSA in 54%.

Those patients with OSA were generally older, had a higher BMI, and were less likely to have suffered trauma or a traumatic brain injury compared with those who did not have sleep apnea (all P≤0.001).

Orr's group cautioned that they were unable to determine how many of the service members in the study had OSA before being deployed -- but the researchers assumed that it was largely preexistent.

High medication use, including painkillers and sedatives, might have contributed to the sleep characteristics of these populations, the investigators noted.

But Orr pointed out that comorbid depression and use of medication were similar in PTSD patients with and without OSA. Also, "the injured population had less obstructive sleep apnea, so if the narcotics were causing central apneas then why was it the opposite?" he asked.

The study was limited to service members returning from combat situations. But in terms of generalizability, Orr noted that sleep disordered breathing was almost universal in a prior study of female sexual assault victims and in another study conducted among crime victims with sleep problems -- most of whom also had PTSD.

One problem with finding sleep apnea in this fairly young PTSD population was that compliance with treatment -- continuous positive airway pressure (CPAP) -- is a problem, cautioned co-author Jacob Collen, MD, also of Walter Reed.

Whether CPAP -- if adhered to -- can actually reverse some of the symptoms of PTSD still remains to be seen, he said in an interview with MedPage Today.

[mrs rockman (widow of vet)]

The rest of this article can be found on; http://www.medpageto....cfm?tbid=23074

MedPage Today Action Points

• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  
• Explain to interested patients that almost all combat veterans with post-traumatic stress disorder (PTSD) (98%) have a sleep disorder -- with more cases of sleep apnea than might otherwise be expected.
  
• Note that just more than half (54%) of these military PTSD patients were diagnosed with obstructive sleep apnea.

This info was very informative. Thank you. I never did link the two together. I go back on the 2nd of December for another echo etc. I know since doing all of this more and more things are popping up with regards to PTSD. I wake up several times each night. Sometimes I can remeember the dreams and sometimes I do not. I go back to the Mental Health lady the end of November to begin my 12 week treatment program. It sometimes feels like I am just getting worse and I guess that is normal, I am not sure. Will post on how it is going.

[mrs rockman (widow of vet)]

I am glad to see a "medical professional" begin to put this common sense into writing. They have for years noted that disrupted sleep is contibutory to developing OSA. Some studies have suggested that disrupted sleep screws up the balance of the hormones and peptides(? not sure if it is right word) which causes some people to begin gaining weight (influences saity/ hunger and metabolism), the weight gain pushes them into OSA, the OSA further excaberates the hormone problem, energy levels drop-activity drops, weight continues to build.....

I am pretty sure my OSA started in Korea. Never knew that those comfy quanset hut's with the deisel heaters, a 50 yard walk to the latrine in the middle of the night, and some of the hardest partying Artillerymen this side of Hell would have such a longterm effect. Unfortunately very few medical researchers would be allowed to publish a connection like that.

On The Minute!

Best regards,

Tyler

The medical professionals were not with the well known VA, but with my private cardiologist. Everytime I go to the cardiologist, I fax the pulmonologist at the VA my report and also claims. I will wait on these to go to claims, for it will only put me further back in my "claims basket of hopes". Last time they had to send it back for review. I know that this only hepled my case.

This is the best sight for information you can use to help you and I am so thankful that I found it.

Have a grat day!

rockman