Updated at: 11-03-2022 - By: Jane Brody

Traumatic events, such as war, criminal assault, abuse, terrorism, natural disasters, and vehicle or plane crashes, can cause post-traumatic stress disorder (PTSD). The National Center for PTSD believes that between 7% and 8% of the population suffers from PTSD at some point. Some of the most common symptoms of post-traumatic stress disorder include flashbacks, memory issues, and increased sensitivity to being startled.

The inability to sleep is another common symptom of post-traumatic stress disorder (PTSD). Insomnia and nightmares are the two most common sleep disturbances associated with PTSD. New research shows a strong link between sleep apnea and post-traumatic stress disorder (PTSD).

Obstructive Sleep Apnea (OSA) is characterized by snoring, choking, or gasping noises during the night, which might be caused by a blocked airway. Disruption of sleep is caused by the brain’s need to restart breathing when these symptoms occur That’s why those who suffer from OSA wake up feeling groggy and groggy all day long, even after sleeping through the night.

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OSA and PTSD co-occurring how often? Between 17% and 22% of the overall population suffers from OSA. This percentage can range from 12 to 90% in those suffering from post-traumatic stress disorder. Individuals with OSA and PTSD are more likely to experience more severe PTSD symptoms than those without both conditions.

It is possible to have sleep-disordered breathing, which is linked to an increased risk of heart failure, dementia, and some malignancies in those with untreated OSA. People who had to flee a fire were found to have sleep-disordered breathing in 95% of them, and 91% of those who had to deal with multiple crimes.

Veterans are three times more likely to suffer from post-traumatic stress disorder (PTSD). Having sleep apnea is more common among male veterans, who make up a bigger fraction of the total population of veterans. One study found that 69% of Vietnam soldiers with PTSD also suffered from sleep apnea.

The prevalence of sleep apnea increases with age in the general population. Young veterans with PTSD, on the other hand, maybe at more risk than the average person their age. Over two-thirds of those who served in the wars in Iraq and Afghanistan were found to have OSA.

As a result, those with PTSD who also suffer from OSA are more likely to suffer from depression, a higher risk of suicide, and a lower quality of life. Individuals under the age of 70 who are diagnosed with OSA face a higher chance of dying young.

Does PTSD Cause Sleep Apnea?

Is sleep apnea linked to post-traumatic stress disorder (PTSD) or the other way around? It’s difficult to say. As measured by the number of times a person pauses breathing for more than 10 seconds per hour, those with more severe OSA are more likely to suffer from more severe PTSD. The more severe their PTSD is, the more severe their OSA is as well. A veteran’s risk of OSA increased by 40% for every clinically significant rise in the severity of his or her PTSD symptoms.

Sleep apnea can increase PTSD symptoms by causing sleep loss, which can make it more difficult to recover. Arousal of the sympathetic nervous system, even if a sleeper does not wake up while suffering OSA symptoms, decreases overall sleep quality. As a result of sleep deprivation, a person may be less likely to use CPAP therapy, the most popular treatment for sleep apnea, which can negatively impact mood and decision-making.

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Fear Extinction and REM Sleep

People with post-traumatic stress disorder (PTSD) can benefit greatly from getting a good night’s sleep, which helps to alleviate the terror that accompanies terrible memories. Fear extinction occurs when your brain forgets the connection between a neutral trigger and an emotional response. Research shows that sleep, particularly rapid eye movement (REM) sleep, aids in this process. Reducing the dread associated with particular memories during REM sleep is similar to how your brain consolidates and remembers events during this stage of sleep.

REM sleep is when both fear extinction and nightmares occur. Trauma-affected individuals’ REM sleep is disrupted when they wake up from nightmares, which can be detrimental to their ability to overcome their ingrained fears. If a person has sleep apnea, they are more likely to have a disrupted night’s sleep. The majority of apneas for some people with OSA occur during REM sleep.

Sleep apnea may be linked to post-traumatic stress disorder (PTSD), according to certain studies. Reduced growth hormone (GH) secretion is linked to greater nighttime awakenings in people with post-traumatic stress disorder (PTSD). Frequent awakenings are another symptom of chronic stress, which is common in PTSD patients.

Treating Sleep Apnea and PTSD

In addition, to talk therapy and medication, better sleep hygiene is often included in the treatment of PTSD because difficulty sleeping is a common arousal symptom. For those who suffer from insomnia, doctors may advise that you adhere to a regular sleep schedule, develop a relaxing nighttime ritual, and limit your intake of coffee and alcohol.

Patients with obesity-related sleep apnea may benefit from weight loss surgery or a diet and exercise regimen in addition to CPAP therapy. Individuals use a CPAP mask while they sleep, which is connected to a CPAP machine on their bedside table through a hose. Apnea episodes are reduced by using CPAP therapy, which keeps the airways open throughout sleep.

There is good news for patients with sleep apnea and PTSD, as evidence shows that CPAP therapy can help alleviate symptoms of both conditions. This includes anxiety and despair as well as nightmares and poor quality of life. Untreated OSA has been linked to worse results for PTSD, while the opposite is true.

Adherence to CPAP Therapy

Because wearing a CPAP mask while you sleep is inconvenient, it is less usual than doctors would want for patients to stick with their treatment plan. Because of their fear of claustrophobia and nightmares, people with post-traumatic stress disorder (PTSD) are substantially less likely to undergo CPAP therapy on a regular basis. CPAP therapy is more difficult to tolerate in people who have frequent nightmares. Patients with post-traumatic stress disorder (PTSD) utilize CPAP therapy for fewer nights and for shorter periods of time (an average of 3.5 hours).

Veterans without post-traumatic stress disorder (PTSD) were found to adhere to CPAP therapy 70% of the time, according to research. Veterans with post-traumatic stress disorder (PTSD) had a lower rate of adherence.

Non-compliance with CPAP therapy might have catastrophic ramifications. Study participants with post-traumatic stress disorder (PTSD) and OSA saw 75% improvement in their symptoms when they followed their CPAP therapy. Those who failed to do so had a 43 percent increase in the severity of their symptoms.

People with post-traumatic stress disorder (PTSD) who utilize their CPAP therapy more regularly had better outcomes. CPAP therapy has a greater favorable impact on those with severe PTSD symptoms than those with mild to moderate symptoms.

Individuals with post-traumatic stress disorder (PTSD) who use CPAP therapy can reduce the frequency of their nightmares by as much as 50%, as well as the pain they cause. CPAP therapy also helps with PTSD’s daytime sleepiness, which enhances one’s overall well-being.

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When It’s Time To See Your Doctor About Sleep Apnea

If you have PTSD and are concerned that you may have sleep apnea, you should contact a doctor if any of the following applies to you:

  • Your companion has complained about your loud snoring or breathing pauses while you sleep.
  • You wake up in the middle of the night, gasping for air or clutching your throat.
  • After a full night’s sleep, you still feel exhausted.
  • At school, work, or while driving, you find it difficult to concentrate.

Talk to your doctor if you observe any of the following symptoms. Treatment for PTSD and OSA symptoms can be greatly improved with regular use of CPAP and talk therapy as well as other forms of therapy.

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