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Posttraumatic Stress Disorder and Obstructive Sleep Apnea in Twins.
Amit J Shah1,2,3, Viola Vaccarino1,2, Jack Goldberg4,5
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
JAMA Network Open
|June 24, 2024
Summary
Posttraumatic stress disorder (PTSD) is linked to more severe obstructive sleep apnea (OSA) in older male veterans. This study highlights the connection between PTSD symptoms and sleep-disordered breathing, informing potential treatment strategies.
Area of Science:
- Sleep Medicine
- Psychiatry
- Epidemiology
Background:
- Obstructive sleep apnea (OSA) is prevalent in older adults, yet mechanistic research for personalized treatments is lacking.
- Previous studies suggest an association between OSA and posttraumatic stress disorder (PTSD), but are limited by potential selection bias.
Purpose of the Study:
- To investigate the association between current PTSD symptoms and diagnosed PTSD with OSA in older male veterans.
- To explore potential mechanistic insights into both conditions by evaluating confounders.
Main Methods:
- Cross-sectional study utilizing twin pairs discordant for PTSD to control for familial factors.
- In-laboratory polysomnography to assess obstructive sleep apnea (OSA) via apnea-hypopnea index (AHI).
- PTSD symptoms assessed using the PTSD Checklist (PCL) and structured clinical interview for diagnosis.
Main Results:
- Each 15-point increase in PCL score was associated with a 4.6 events-per-hour higher AHI.
- Current PTSD diagnosis was linked to a 10.5 events-per-hour higher AHI.
- Standardized estimates showed comparable associations of PTSD symptoms and BMI with AHI.
Conclusions:
- This study confirms an association between PTSD and sleep-disordered breathing in older male veterans.
- Findings have public health implications and may improve understanding of OSA pathophysiology.
- Individualized treatment approaches for OSA may benefit from considering PTSD status.
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