Colvonen Peter J, Masino Tonya, Drummond Sean P A, Myers Ursula S, Angkaw Abigail C, Norman Sonya B
VA San Diego Healthcare System and Department of Psychiatry, University of California, San Diego, CA.
Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA.
J Clin Sleep Med. 2015 Apr 15;11(5):513-8. doi: 10.5664/jcsm.4692.
This study examined: (a) the relationship between self-reported posttraumatic stress disorder (PTSD) symptoms and risk of obstructive sleep apnea (OSA) in a younger, Iraq and Afghanistan (OEF/OIF/OND) veteran sample seeking treatment for PTSD; and (b) the relationships between PTSD symptom scores and each risk factor of OSA (snoring, fatigue, high blood pressure/BMI).
Participants were 195 Iraq and Afghanistan veterans presenting to a VA outpatient PTSD clinic for evaluation. Veterans were 21 to 59 years old (mean 33.40, SD 8.35) and 93.3% male (n = 182). Logistic regressions were run to examine whether veterans with greater PTSD symptom severity had an increased probability of screening as high risk for OSA, even after controlling for known risk factors (older age, positive smoking status, and use of CNS depressants).
Of 159 veterans screened, 69.2% were assessed as being at high risk for OSA. PTSD symptom severity increased the risk of screening positive for OSA. PTSD symptom severity increased risk of screening positive for snoring and fatigue, but not high blood pressure/BMI.
OEF/OIF/OND veterans with PTSD screen as high risk for OSA at much higher rates than those seen in community studies and may not show all classic predictors of OSA (i.e., older and higher BMI). This study is the first to suggest that the Berlin may be a useful screener for OSA in a younger OEF/OIF/OND veteran population with PTSD. Screening of younger veterans with PTSD for OSA should be standard care, and polysomnography and OSA interventions should be readily available to younger veterans.
本研究调查了：（a）在寻求创伤后应激障碍（PTSD）治疗的较年轻的伊拉克和阿富汗（OEF/OIF/OND）退伍军人样本中，自我报告的创伤后应激障碍症状与阻塞性睡眠呼吸暂停（OSA）风险之间的关系；以及（b）创伤后应激障碍症状评分与阻塞性睡眠呼吸暂停的每个风险因素（打鼾、疲劳、高血压/体重指数）之间的关系。
参与者为195名前往退伍军人事务部门诊PTSD诊所进行评估的伊拉克和阿富汗退伍军人。退伍军人年龄在21至59岁之间（平均33.40岁，标准差8.35），93.3%为男性（n = 182）。进行逻辑回归分析，以检验即使在控制已知风险因素（年龄较大、吸烟阳性状态和使用中枢神经系统抑制剂）后，创伤后应激障碍症状严重程度较高的退伍军人筛查为阻塞性睡眠呼吸暂停高风险的可能性是否增加。
在接受筛查的159名退伍军人中，69.2%被评估为阻塞性睡眠呼吸暂停高风险。创伤后应激障碍症状严重程度增加了阻塞性睡眠呼吸暂停筛查呈阳性的风险。创伤后应激障碍症状严重程度增加了打鼾和疲劳筛查呈阳性的风险，但未增加高血压/体重指数筛查呈阳性的风险。
患有创伤后应激障碍的OEF/OIF/OND退伍军人筛查为阻塞性睡眠呼吸暂停高风险的比例远高于社区研究中的比例，并且可能未表现出阻塞性睡眠呼吸暂停的所有典型预测因素（即年龄较大和体重指数较高）。本研究首次表明，柏林问卷可能是筛查患有创伤后应激障碍的较年轻OEF/OIF/OND退伍军人阻塞性睡眠呼吸暂停的有用工具。对患有创伤后应激障碍的较年轻退伍军人进行阻塞性睡眠呼吸暂停筛查应成为标准护理，并且多导睡眠图检查和阻塞性睡眠呼吸暂停干预措施应随时可供较年轻退伍军人使用。
