Response to Cognitive Processing Therapy in Veterans With and Without Obstructive Sleep Apnea.

Area of Science:

• Psychiatry
• Sleep Medicine
• Clinical Psychology

Background:

• Trauma-focused psychotherapies like CPT need outcome enhancement for veterans.
• Sleep disturbances are common in PTSD and affect emotional processing.
• Obstructive sleep apnea (OSA) is prevalent in veterans with PTSD, but its treatment impact is unknown.

Purpose of the Study:

• To investigate the impact of OSA on CPT treatment outcomes in veterans with PTSD.
• To explore whether continuous positive airway pressure (CPAP) therapy modifies this impact.

Main Methods:

• Retrospective chart review of 344 veterans undergoing CPT.
• Comparison of PTSD symptom severity between OSA-positive (n=68) and OSA-negative (n=276) groups.
• Analysis using generalized estimating equations to assess treatment response.

Main Results:

• OSA-positive veterans reported significantly greater PTSD severity throughout CPT and at posttreatment compared to OSA-negative veterans.
• OSA-positive veterans with access to CPAP therapy showed reduced PTSD severity compared to those without CPAP access.
• Apnea appears to reduce CPT effectiveness, but CPAP may mitigate this effect.

Conclusions:

• OSA is associated with poorer treatment outcomes in veterans with PTSD undergoing CPT.
• CPAP therapy shows potential for improving CPT effectiveness in veterans with PTSD and OSA.
• Further research is warranted to confirm CPAP's role in mitigating OSA's impact on psychotherapy outcomes.