Modeling the effects of obstructive sleep apnea and hypertension in Vietnam veterans with PTSD

Kinoshita, Lisa M.; Yesavage, Jerome A.; Noda, Art; Jo, Booil; Hernandez, Beatriz; Taylor, Joy L.; Zeitzer, Jamie M.; Friedman, Leah; Fairchild, J. Kaci; Cheng, Jun; Kuschner, Ware G.; O’Hara, Ruth; Holty, Jon-Erik C; Scanlon, Blake K.

doi:10.1007/s11325-011-0632-8

Cited by 26 publications

(26 citation statements)

References 33 publications

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“…Our sleep apnea findings in older, male veterans are supported by previous studies including a prospective study in older women which found an association between sleep apnea and an increased risk of dementia [4] as well as a cross-sectional study in older Vietnam-era veterans which found that obstructive sleep apnea severity was associated with worse cognitive performance [12].…”

Section: Resultssupporting

confidence: 88%

Sleep Quality and Risk of Dementia Among Older Male Veterans

Yaffe

Nettiksimmons

Yesavage

et al. 2015

The American Journal of Geriatric Psychiatry

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Section: Resultssupporting

confidence: 88%

Sleep Quality and Risk of Dementia Among Older Male Veterans

Yaffe

Nettiksimmons

Yesavage

et al. 2015

The American Journal of Geriatric Psychiatry

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“…Kinoshita (83%) and Yesavage (69%) required participants to be male, aged ≥ 55 with a CAPS score ≥ 40, each of which acts as a selection bias towards increased OSA prevalence. 41,42 Two studies by Mysliwiec 26,43 examined postcombat PSG in military personnel, and the second of these 43 required a PTSD Checklist Military Version score ≥ 50, both of which act as selection biases. The van Liempt study also included male veterans with a CAPS score > 50.…”

Section: 2640-44mentioning

confidence: 99%

“…[24][25][26][39][40][41][42][43][44] The clinic-based studies reported a prevalence range of 0.7% to 83%.…”

mentioning

confidence: 99%

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Obstructive Sleep Apnea and Psychiatric Disorders: A Systematic Review

Gupta

Simpson

2015

Journal of Clinical Sleep Medicine

258

156

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Study Objectives: Obstructive sleep apnea (OSA) has been associated with psychiatric pathology. Psychiatric comorbidity in OSA may affect patient quality of life and adherence to CPAP. A focused evaluation of OSA in highly selected groups of primarily psychiatric patients may provide further insights into the factors contributing to comorbidity of OSA and psychopathology. The goal of this study is to examine the prevalence and treatment of OSA in psychiatric populations. Methods: A systematic review following the PRISMA guidelines was conducted to determine the prevalence of OSA in schizophrenia and other psychotic disorders, mood disorders, and anxiety disorders, and to examine potential interventions. The PubMed, EMBASE, and PsycINFO databases were searched (last search April 26, 2014) using keywords based on the ICD-9-CM coding for OSA and the DSM-IV-TR diagnostic groups. Results: The search retrieved 48 records concerning studies of OSA in the selected disorders. The prevalence studies indicate that there may be an increased prevalence of OSA in individuals with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), despite considerable heterogeneity and a high risk of bias. There was insuffi cient evidence to support increased OSA in schizophrenia and psychotic disorders, bipolar and related disorders, and anxiety disorders other than PTSD. Studies of treatment of OSA indicate an improvement in both OSA and psychiatric symptoms. CPAP adherence was reduced in veterans with PTSD. Conclusions: OSA prevalence may be increased in MDD and PTSD. In individuals with OSA and psychiatric illness, treatment of both disorders should be considered for optimal treatment outcomes. 1 According to a major US study of OSA diagnosed by polysomnography (PSG), the prevalence of OSA, as defi ned by an apnea-hypopnea index (AHI) ≥ 5 and without inclusion of a daytime sleepiness criterion, was reported as 24% for men and 9% for women under the age of 65 years; addition of a daytime sleepiness criterion reduced these estimates to 4% for men and 2% for women. 1,2 OSA is commonly associated with metabolic syndrome including comorbid obesity, hypertension, and diabetes.1 Upper airway obstruction may present as apneas, hypopneas, or respiratory effort-related arousals (RERAs), resulting in oxygen desaturation, repeated arousals and sleep fragmentation. Recently, there has been an increase in reports of comorbidity of OSA with psychological/psychiatric symptoms. Psychiatric comorbidity in OSA has been reported to adversely affect the quality of life of OSA patients and adherence to CPAP therapy. 3-5Psychological symptoms such as depression and anxiety are commonly reported in adults with OSA; however, the relationship between OSA and full psychiatric syndromes is less clear. Global prevalence studies and reviews have suggested that there are elevated rates of psychological symptoms in individuals with OSA. [17][18][19] Studies that have evaluated the prevalence of OSA in the highly selected groups of psychiatric popu...

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“…Kinoshita et al (2012) conducted a study through a PTSD Sleep Apnea Clinic, recruiting 120 PTSD patients to evaluate cognitive function. Patients currently treated for sleep apnea (e.g., corrective surgery, PAP-T) were excluded.…”

mentioning

confidence: 99%