A Prospective Evaluation of PTSD Symptoms following CPAP Treatment for Sleep-disordered Breathing in Veterans

Abstract

Previous research has observed elevated rates of OSA observed in individuals with PTSD compared to the general population. Retrospective studies suggest that successful treatment of OSA in individuals with PTSD is related to reductions in nightmares and overall PTSD symptom severity. The purpose of the current study was to extend this research by prospectively examining PTSD sympomatology in a sample of Veterans initiating treatment for OSA. Participants were 47 Veterans presenting to a VAMC Neurology Sleep Clinic for overnight polysomnography. Veterans were eligible if they were: (a) diagnosed with OSA; (b) received continuous positive airway pressure (CPAP) treatment; and (c) had a minimum score of 25 on the baseline administration of the PCL. The majority of the sample were male (n = 42; 89.4%) and Caucasian (n = 23; 48.9%) or African American (n = 22; 46.8%), with a mean age of 53.5 years. Veterans completed self-report questionnaires across two pre-treatment and two post-treatment (two weeks and four weeks from treatment initiation) time points. A 2 (treatment compliance status) x 4 (time) mixed model repeated measures analysis was conducted on PTSD symptom severity as measured by the PCL administered at each time point. A statistically significant compliance status x time interaction emerged, (F(3, 102.15) = 5.66. p = .001) such that CPAP-compliant Veterans reported a statistically significant reduction in PTSD symptoms from pre to post-treatment, whereas CPAP non-compliant Veterans did not. These findings suggest that successful treatment of a physical sleep disorder like OSA is associated with a subsequent reduction of posttraumatic distress

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