What is Sleep Apnea?
Sleep apnea is a condition in which someone has recurring pauses or reductions in breathing during sleep. The most common type of sleep apnea, obstructive sleep apnea (OSA), affects between 10% and 30% of U.S. adults. Untreated sleep apnea can lead to poor sleep quality, daytime sleepiness, and other health issues.
PTSD and Sleep Quality
Sleep disturbances are a major problem for many people with PTSD, with nightmares and insomnia being common symptoms of the condition. Other sleep issues, including sleep apnea and fragmented sleep, are also linked to PTSD. Sleep problems and PTSD can interact to create a vicious cycle. PTSD may make it hard to go to sleep, while lack of sleep can worsen PTSD symptoms. A study found that insomnia symptoms both precede and follow PTSD symptoms, with sleep problems possibly forming the first symptom of PTSD. This suggests that insomnia may be a predictor of PTSD.
PTSD and Sleep Apnea
Poor sleep can lead to problems with physical and mental health. One of the body's main wakefulness centers controls the arousal of the fight-or-flight response that is common in people with PTSD. Citing the correlation between PTSD and sleep apnea, research suggests that a poor sleep quality exacerbates PTSD symptoms. Childhood trauma, which is a contributing factor to PTSD, may also increase the risk of having sleep apnea later in life. A study found that childhood trauma was associated with increased risk of developing sleep apnea. The same study found that the risk of obstructive sleep apnea increase as the severity and number of adversities reported increases.
Special Considerations for Veterans with PTSD
All veterans experience combat and other possible traumas during the course of service, so it is unsurprising that sleep disorders and PTSD are common in returning veterans. Obstructive sleep apnea (OSA) is linked to PTSD in veterans, and researchers suggest that OSA may interact with PTSD to increase the risk of other medical issues. Using a nationally sampled study, researchers concluded that PTSD was significantly associated with sleep-related breathing disorders. Veterans with PTSD were twice as likely to have OSA than those without PTSD. It is important that veterans are able to spot potential symptoms of PTSD and sleep apnea, and that they receive necessary treatment for both conditions.
Treating PTSD and Sleep Apnea
Treatment of PTSD and sleep apnea is an essential priority for veterans due to the high prevalence of each condition in the veteran population. If you are a veteran and are experiencing either of these conditions, there are multiple treatment options available. Several treatments are available to treat PTSD, including psychotherapy and medications. Psychotherapy options include treatments such as cognitive behavioral therapy (CBT), which helps a person process and make sense of their trauma. Medication can help to reduce the intensity of symptoms in people with PTSD. Popular medications include selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and atypical antipsychotics.
Positive Airway Pressure (PAP) machines are the most common and effective treatment for sleep apnea. These devices deliver air through a face or nasal mask worn while sleeping. The purpose of PAP therapy is to maintain an open airway, allowing a person to sleep more peacefully.
If a person has both PTSD and sleep apnea, it is important that both conditions be addressed together and that the treatments do not interfere with one another. For example, certain medications often used to treat PTSD may aggravate sleep apnea symptoms including weight gain, daytime sleepiness, and slowed respiratory rates. If both things are occurring, a medical professional should adjust the medications to counterbalance the side effects.
Physically addressing the risk factors of PTSD, such as obesity, cognitive behavior therapy, good sleep hygiene, and alcohol avoidance might also help improve sleep apnea symptoms. In some cases, lifestyle changes, such as maintaining a healthy diet and exercising regularly, can be beneficial for addressing both PTSD and sleep apnea.