Effects of CPAP Therapy on PTSD Symptoms
| Status: | Completed |
|---|---|
| Conditions: | Insomnia Sleep Studies, Psychiatric, Pulmonary, Pulmonary |
| Therapuetic Areas: | Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | July 2013 |
| End Date: | June 2015 |
Effects of Continuous Positive Airway Pressure Therapy for Obstructive Sleep Apnea on PTSD Symptoms
The purpose of this study is to evaluate the effects of treating Obstructive Sleep Apnea
(OSA) with continuous positive airway pressure (CPAP) therapy on symptoms of post traumatic
stress disorder (PTSD). The study hypotheses are that CPAP use will improve PTSD symptoms
overall and that CPAP use will improve sleep quality and duration, nocturnal symptoms
related to PTSD, mood, daytime sleepiness, sleep-related quality of life, and general health
perception.
(OSA) with continuous positive airway pressure (CPAP) therapy on symptoms of post traumatic
stress disorder (PTSD). The study hypotheses are that CPAP use will improve PTSD symptoms
overall and that CPAP use will improve sleep quality and duration, nocturnal symptoms
related to PTSD, mood, daytime sleepiness, sleep-related quality of life, and general health
perception.
Post traumatic stress disorder (PTSD) is associated with increased healthcare utilization,
decreased functional status, and overall poor health. Sleep disturbances in PTSD are common,
including nightmares, dream enactment, and poor sleep quality. Obstructive sleep apnea (OSA)
is also highly prevalent in the veteran population and may exacerbate PTSD symptoms by
triggering arousals from sleep that promote recollection of dreams, enactment of dreams, and
disrupt sleep continuity. Improvements in sleep quality and PTSD symptoms have been reported
when OSA is treated with continuous positive airway pressure (CPAP) therapy. However, formal
assessment using validated questionnaires and documentation of CPAP compliance to correlate
with these tools has not yet been performed. This study will recruit veterans with PTSD who
have been newly diagnosed with OSA and who are willing to try CPAP therapy. Baseline
assessments of PTSD symptoms, daytime sleepiness, sleep-related quality of life, sleep
quality, general health perception, and mood will be performed before initiation of
treatment and after 3 and 6 months of therapy.
This study will have the following specific aims:
Aim 1: To evaluate the effect of CPAP use on PTSD symptoms.
Hypothesis: After 6 months of treatment, CPAP use will improve PTSD symptoms as assessed by
the PTSD checklist (PCL-S).
Aim 2: To evaluate the effect of CPAP use on 1)sleep quality and duration, 2)nocturnal
symptoms of nightmares, movement disorders, dream enactment, and insomnia, 3)mood, 4)daytime
sleepiness, 5)sleep-related quality of life, and 6) general health perception.
Hypothesis: After 6 months of treatment, CPAP use will improve sleep quality, sleep
duration, mood, daytime sleepiness, sleep-related quality of life, general health
perception, and nocturnal symptoms of nightmares, movement disorders, dream enactment, and
insomnia.
decreased functional status, and overall poor health. Sleep disturbances in PTSD are common,
including nightmares, dream enactment, and poor sleep quality. Obstructive sleep apnea (OSA)
is also highly prevalent in the veteran population and may exacerbate PTSD symptoms by
triggering arousals from sleep that promote recollection of dreams, enactment of dreams, and
disrupt sleep continuity. Improvements in sleep quality and PTSD symptoms have been reported
when OSA is treated with continuous positive airway pressure (CPAP) therapy. However, formal
assessment using validated questionnaires and documentation of CPAP compliance to correlate
with these tools has not yet been performed. This study will recruit veterans with PTSD who
have been newly diagnosed with OSA and who are willing to try CPAP therapy. Baseline
assessments of PTSD symptoms, daytime sleepiness, sleep-related quality of life, sleep
quality, general health perception, and mood will be performed before initiation of
treatment and after 3 and 6 months of therapy.
This study will have the following specific aims:
Aim 1: To evaluate the effect of CPAP use on PTSD symptoms.
Hypothesis: After 6 months of treatment, CPAP use will improve PTSD symptoms as assessed by
the PTSD checklist (PCL-S).
Aim 2: To evaluate the effect of CPAP use on 1)sleep quality and duration, 2)nocturnal
symptoms of nightmares, movement disorders, dream enactment, and insomnia, 3)mood, 4)daytime
sleepiness, 5)sleep-related quality of life, and 6) general health perception.
Hypothesis: After 6 months of treatment, CPAP use will improve sleep quality, sleep
duration, mood, daytime sleepiness, sleep-related quality of life, general health
perception, and nocturnal symptoms of nightmares, movement disorders, dream enactment, and
insomnia.
Inclusion Criteria:The intent is to recruit a study population that is as representative
as possible of the veteran PTSD population. Thus, entry criteria are as inclusive as
possible:
- age >18 year
- confirmed diagnosis of PTSD (PCL checklist minimum score of 45)
- confirmed diagnosis of sleep apnea (apnea hypopnea index >5/h)
- newly starting CPAP (not previously treated)
Exclusion Criteria:
- fatal co-morbidity with life expectancy of less than 6 months,
- residing in a geographically remote area that would make follow up at 3 and 6 months
difficult.
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