Ali A El-Solh1,2,3, David Adamo4, Thomas Kufel4,5. 1. VA Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY, 14215, USA. solh@buffalo.edu. 2. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA. solh@buffalo.edu. 3. Department of Epidemiology and Environmental Health, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA. solh@buffalo.edu. 4. VA Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY, 14215, USA. 5. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA.
Abstract
PURPOSE: The purpose of this study was to determine the impact of insomnia in Veterans with post-traumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) on health-related outcomes before and after 12 weeks of continuous positive airway pressure (CPAP) treatment. METHODS: We conducted a prospective cohort study of Veterans with PTSD and documented apnea hypopnea index (AHI) ≥ 5 with and without clinically significant insomnia as determined by the Insomnia Severity Index (ISI). Health-related outcomes including PTSD checklist (PCL-M), SF-36, and Pittsburgh Sleep Quality Index (PSQI) were assessed at baseline and 12 weeks after initiation of OSA treatment. CPAP adherence was retrieved at each visit. RESULTS: Seventy-two Veterans including 36 with comorbid insomnia and OSA (COMISA) and 36 OSA-only were enrolled. Veterans with COMISA were younger (p = 0.03), had lower BMI (p < 0.001), and were more likely to report depression than those with OSA-only (p = 0.004). Although AHI was higher in the COMISA (p = 0.01), both groups expressed comparable daytime sleepiness (p = 0.16). The COMISA group had no significant change in SF-36 and PSQI after 12 weeks of treatment and used CPAP much less frequently than OSA-only group (p = 0.001). CONCLUSIONS: COMISA in Veterans with PTSD is associated with worse quality of life than those with OSA-only. Insomnia should be assessed in Veterans with PTSD who are not adherent to CPAP treatment.
PURPOSE: The purpose of this study was to determine the impact of insomnia in Veterans with post-traumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) on health-related outcomes before and after 12 weeks of continuous positive airway pressure (CPAP) treatment. METHODS: We conducted a prospective cohort study of Veterans with PTSD and documented apnea hypopnea index (AHI) ≥ 5 with and without clinically significant insomnia as determined by the Insomnia Severity Index (ISI). Health-related outcomes including PTSD checklist (PCL-M), SF-36, and Pittsburgh Sleep Quality Index (PSQI) were assessed at baseline and 12 weeks after initiation of OSA treatment. CPAP adherence was retrieved at each visit. RESULTS: Seventy-two Veterans including 36 with comorbid insomnia and OSA (COMISA) and 36 OSA-only were enrolled. Veterans with COMISA were younger (p = 0.03), had lower BMI (p < 0.001), and were more likely to report depression than those with OSA-only (p = 0.004). Although AHI was higher in the COMISA (p = 0.01), both groups expressed comparable daytime sleepiness (p = 0.16). The COMISA group had no significant change in SF-36 and PSQI after 12 weeks of treatment and used CPAP much less frequently than OSA-only group (p = 0.001). CONCLUSIONS: COMISA in Veterans with PTSD is associated with worse quality of life than those with OSA-only. Insomnia should be assessed in Veterans with PTSD who are not adherent to CPAP treatment.
Entities:
Keywords:
Adherence; CPAP; Comorbid insomnia; Quality of life; Sleep apnea
Authors: Erla Björnsdóttir; Christer Janson; Thorarinn Gíslason; Jón F Sigurdsson; Allan I Pack; Philip Gehrman; Bryndís Benediktsdóttir Journal: J Sleep Res Date: 2011-10-12 Impact factor: 3.981
Authors: Erla Björnsdóttir; Christer Janson; Jón F Sigurdsson; Philip Gehrman; Michael Perlis; Sigurdur Juliusson; Erna S Arnardottir; Samuel T Kuna; Allan I Pack; Thorarinn Gislason; Bryndis Benediktsdóttir Journal: Sleep Date: 2013-12-01 Impact factor: 5.849
Authors: Barry Krakow; Dominic Melendrez; Samuel A Lee; Teddy D Warner; Jimmy O Clark; David Sklar Journal: Sleep Breath Date: 2004-03 Impact factor: 2.816
Authors: Tarja Saaresranta; Jan Hedner; Maria R Bonsignore; Renata L Riha; Walter T McNicholas; Thomas Penzel; Ulla Anttalainen; John Arthur Kvamme; Martin Pretl; Pawel Sliwinski; Johan Verbraecken; Ludger Grote Journal: PLoS One Date: 2016-10-04 Impact factor: 3.240