The Association between PTSD and Sleep Apnea

Linking PTSD to Sleep Apnea among Veterans

Today, nearly 40 million American adults suffer from obstructive or central sleep apnea and far too many of them, perhaps as many as 7 million people, do not even realize they have the disorder (Stiles, 2024). This is an important issue because left untreated, sleep apnea of either type can cause a wide array of medical issues including kidney, heart and metabolic health problems (Stiles, 2024). Moreover, these are also important issues for military veterans who suffer from post-traumatic stress disorder (PTSD). Indeed, combat veterans suffer from PTSD at far greater rates than noncombat veterans or the general public, and estimates indicate that there are approximately 300,00 combat veterans who suffer from PTSD at present (Post-traumatic Stress Disorder, 2024).

Although the precise causes of sleep apnea remain unclear, there is a positive link between the disorder and many of the symptoms that veterans suffering from PTSD experience. For instance, according to one authority, “Depression and PTSD show up at higher rates in people with [sleep apnea] compared to people without, though the research has yet to uncover if or how one condition causes the other” (Stiles, 2024, para. 7). Because many veterans, especially combat veterans, suffer from depression and substance abuse, there is a growing recognition of the link with this disorder and sleep apnea.

Although there is no direct causal link between PTSD and sleep apnea, both conditions appear to predispose individuals to the other. In this regard, Vasta (2021) emphasizes that, “While PTSD does not cause sleep apnea directly, PTSD patients are more likely to have risk factors such as high blood pressure [substance abuse], and obesity [which] tend to cause sleep apnea to become a sleep-related problem impacting their PTSD” (2021, para. 8). In other words, while the precise link between PTSD and sleep apnea remains unclear, it is apparent that military veterans with PTSD are at greater risk of experiencing sleep apnea that others. Unfortunately, since far too many veterans also refuse to seek help for their depressive disorders due to the stigma involved, it is reasonable to suggest that greater efforts on the part of the Department of Veterans Affairs (VA) are needed today to address this public health threat.

Given the significant overlap between PTSD and sleep apnea in military veterans, a comprehensive approach to addressing these interconnected issues is essential. First and foremost, there should be increased screening for sleep apnea among veterans who have been diagnosed with PTSD. This could involve implementing routine sleep studies or questionnaires as part of standard PTSD treatment protocols in VA hospitals and clinics. Likewise, healthcare practitioners treating veterans with PTSD should receive specialized training to recognize the signs and symptoms of sleep apnea. This measure would help ensure early detection and intervention, potentially mitigating the long-term health consequences associated with untreated sleep apnea.

Beyond the foregoing, there is also a need for additional research concerning the relationship between PTSD and sleep apnea. In this regard, although costly and difficult to perform, longitudinal studies could help clarify whether one condition predisposes individuals to the other, or if there are common underlying factors contributing to both (Jankowsky & Schroeders, 2022). This type of research could help develop more targeted and effective treatment strategies for veterans suffering from both conditions.

Finally, integrated treatment approaches should be developed and implemented for the nation’s veteran population. These integrated approaches could combine cognitive-behavioral therapy for PTSD with sleep hygiene education and continuous positive airway pressure therapy for sleep apnea (Sweetman et al., 2019). By addressing both conditions simultaneously, treatment outcomes may be improved for veterans suffering from PTSD, and these findings can help inform treatment strategies for the larger American population.

References

Jankowsky, K., & Schroeders, U. (2022). Validation and Generalizability of Machine Learning Prediction Models on Attrition in Longitudinal Studies. International Journal of Behavioral Development, 46(2), 169–176.