Sleep Apnea and PTSD

[anthony]

I have read here a few times that people mention PTSD and sleep apnea in the same context, ie. they often believe one is linked to another. I thought it would be a more interesting discussion on how one really thinks this, as from all the reading I have done on sleep apnea, the most common cause is from being overweight, which induces the "obstructive" type of sleep apnea.

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency, measured at C3, C4, O1, or O2), a blood oxygen desaturation of 3-4% or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a "Sleep Study" which is often conducted by a pulmonologist.

Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea (from the polysomnogram). There are three distinct forms of sleep apnea: central (0.4%), obstructive (84%), and complex (15%) (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively.

Now... many people who are told they have sleep apnea and then continue onto a oxygen machine or medication to sleep 99% of the time ignore the actual methods in which they can cease it and sleep normally... being:

Obstructive sleep apnea (OSA) is the most common category of sleep-disordered breathing. The muscle tone of the body ordinarily relaxes during sleep and at the level of the throat the human airway is composed of collapsible walls of soft tissue which can obstruct breathing during sleep. Mild, occasional sleep apnea, such as many people experience during an upper respiratory infection may not be important, but chronic, severe obstructive sleep apnea requires treatment to prevent sleep deprivation and other complications. The most serious complication is a severe form of congestive heart failure called cor pulmonale.

Individuals with low muscle tone and soft tissue around the airway (e.g., due to obesity), and structural features that give rise to a narrowed airway are at high risk for obstructive sleep apnea. The elderly are more likely to have OSA than young people. Men are more typical sleep apnea sufferers than women and children, although it is not uncommon in the latter two.

Common symptoms include loud snoring, restless sleep, and sleepiness during the daytime. Diagnostic tests include home oximetry or polysomnography in a sleep clinic.

Some treatments involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, and quitting smoking. Many people benefit from sleeping at a 30 degree elevation of the upper body or higher, as if in a recliner. Doing so helps prevent the gravitational collapse of the airway. Lateral positions (sleeping on a side), as opposed to supine positions (sleeping on the back), are also recommended as a treatment for sleep apnea, largely because the gravitational component is smaller in the lateral position. Some people benefit from various kinds of oral appliances to keep the airway open during sleep. "Breathing machines" like the continuous positive airway pressure (CPAP) may help. There are also surgical procedures to remove and tighten tissue and widen the airway.

So... my question is this: How many with diagnosed sleep apnea are overweight, smokers, do no structured exercise, drink alcohol and take medication?

What is your position on this?

I know that when I was heavily depressed and put on weight, my snoring increased exponentially. I lost weight and my snoring decreased. If I drink alcohol I snore, as alcohol is a muscle relaxant. If I did nothing about the very things I do control, I could have been diagnosed with sleep apnea, though learnt quickly how to combat this and not have such an illness. For the majority as I see it, sleep apnea is actually an illness they can choose to have or not, depending on their lifestyle choices.

 

[Robyn]

So... my question is this: How many with diagnosed sleep apnea are overweight, smokers, do no structured exercise, drink alcohol and take medication?

My DH is obese but has lost a significant amount of weight, he smokes up to two packs a day, doesn't exercise due to health & pain limitations, he doesn't drink, and is on various meds for RLS & RA.

He sleeps primarily on his back because of degenerative disc disease in the lower back prevents him getting comfortable in other positions.

My mentioning the Sleep Apnea in the other thread was merely a listing of what he'd been diagnosed with, not specifically to correlate it to PTSD which I now recognize as a lack of interpretation on my part.

Thanks for the clarification
Hugs
Robyn

 

[2quilt]

I have obstructive sleep apnea and insomnia; I have a cpap machine and sleep medicine.

 

[Dylan]

I had sleep apnea when I was heavier and used the CPAP (continuous positive airway pressure). I do have a thicker neck (so said the doc anyway) and when I gain weight, it settles heavily there. I also smoked a lot when I was younger.

When I lost weight and had the surgery (turbinate reduction/fixed the septum), the apnea went away, although I still do snore (and, yes, it does increase with alcohol and/or sedative drug (i.e. Ambien) usage).

-D

 

[Mina]

I do not have sleep apnea, but my PTSD diagnosis came about in part because my MD thought I did. All the sleep disturbance symptoms I described were so consistent with sleep apnea. He was convinced I had it, even though I am quite thin and fit...I even have a thin family member with it, which apparently is a major indicator/correlation. However, a sleep oxcimetry test (where they monitor your blood oxygen through the night) showed nothing abnormal on several different occasions. No actual sleep apnea, just similar symptoms. It was right after that our marriage counselor suggested PTSD and yep, sure enough.

 

[nic]

I have sleep apnea, and I don't drink, don't smoke, and I'm not overweight. I always had breathing problems during sleep. When I was little, I had my adnoids (sp?) and tonsils removed. (I don't know if it did much; I was too young to remember.) I do find that that sleeping on my side helps...A LOT. (Sleeping on my back, while most comfortable, really increases the sleep apnea for me.) Unfortunately, though, I toss and turn a bit, and even if I go to sleep on my side, I don't always end up that way in the middle of the night.

I never really thought of my sleep apnea as a PTSD problem, though. I do have sleep issues related to PTSD, (anxiety, nightmares, insomnia), but the apnea is totally different.

 

[Claire]

I dont really understand how sleep apnea could be related to PTSD. I haven't got it myself but a close friend has. He isn't overweight in the slightest, he does regular exercise, doesn't smoke or drink much. He is having tests done at the moment but what they have found is his jaw/palate shape is the cause.

 

[anthony]

I have obstructive sleep apnea and insomnia; I have a cpap machine and sleep medicine.

What do you fit though with the causes to sleep apnea 2quilt?

Robyn... not just from your post. I have read this several times within the forum.

 

[frabrne]

at first i must apologize on mine bad english, i am croatian war veteran and i have obstructive sleep apnea, insomnia and ptsd. the bad thing is that i have all physical qualities for apnea - overweight, smoker, short neck. i was register on this forum because i need help to find any researches result which connect apnea and insomnia with ptsd , especially apnea. when i was in hospital for apnea diagnose the most other pacient was also veterans (about 80%) and most off them with ptsd diagnose. this situation give me idea to find are this two diseases in some connection. thanks

 

[missy8888]

Anthony

I do have some answers on Sleep Apnea if your interested. I also went to school for Resp. care and have my certification in polsomnography. ( I took the courses cause both me and my son have asthma.)

I have never pursued that feild cause i already have a career. But i love school and actually have gone for several things.. Anyway, i did have to work in a hospital during my clinicals for a year.( usually 1 day a week from 7pm to 7am).

I can tell you that ANYONE can get sleep apnea.. weight and drugs can be a contributing factor. But so can heart disease.. there is a strong correlation between heart disease and sleep apnea..

many of the patients i hooked up to the equiptment and monitored as a sleep tech student were thin with no history of substance abuse.. i have seen young athletic men in there 20's come in cause their wife complained they snored and would gasp for air...and found out they had sleep apnea.

sure they were ALOT more of the overweight patients who had it, along with a string of other health issues.

So in some cases as in OSA (obstructive sleep apnea) if the weight came off the sleep apnea may or may not subside.. obstructive sleep apnea there IS respitory effort... but no breath..

But there is also Central sleep apnea in which (it has been a few years) but if i remember correctly... there is NO respitory effort and NO breath...
that one is kinda scary cause the body doesnt even try...

as in the OSA, the patients body trys to get air, but its is obstucted and thats when the body gasps....

So basically it is not something a person chooses to have or chooses to keep by not losing weight or changing lifestyles.

I still have all my text books and notes from class..packed away some where in my closet. So if there is anything you want to know i can look it up for you if i don't remember the answer...:smile:

If i can help just let me know

Missy

 

[raku]

Interesting. My father was a vet with PTSD who smoked heavily. He also snored like a chimney. I remember listening to the snoring, then hearing it stop suddenly and hearing nothing, then a sudden snort and hearing him get up. This happened night after night. Wonder if he stopped breathing. His doctor told him to sleep without a pillow, but it didn't stop the snoring completely.

 

[missy8888]

Hmmm

Interesting. My father was a vet with PTSD who smoked heavily. He also snored like a chimney. I remember listening to the snoring, then hearing it stop suddenly and hearing nothing, then a sudden snort and hearing him get up. This happened night after night. Wonder if he stopped breathing. His doctor told him to sleep without a pillow, but it didn't stop the snoring completely.

It sounds like he definately has sleep apnea. I can't beleive his doctor told him to sleep without a pillow... Actually sleeping with the head elevated often helps breathing, so does sleeping on your side rather than in a supine (flat on your back) position.

Was this many years ago? Because years ago a general doctor probably wouldn't have a clue.. Back then usually only a pulmonary or cardiac doctors would know that.

Sleep studies weren't really common back then. In recent years more and more studies have shown the correlation between sleep and other health issues.. So now it has become as main stream as an MRI.

There are sleep labs popping up all over the country and most hospitals also have a sleep labs.. So most doctors will now refer there patients out for a sleep test. Also if they discover that someone does infact have sleep apnea. The doctor will usually order a second sleep test for a CPAP titration. It will be just like the first one except they will also put the patient on the CPAP machine and titraite (adjust the air pressure) until the apneas stop.

When the tech finds the right CPAP setting, the info is recorded and sent to the doctor. And then a Respitory tech will usually meet with the patient either at home or in the office where they will set them up with their own machine and teach them how to use it.

Most people once they get used to it.. cause it is noisy...and the mask can be weird) actually start feeling alot better and have more energy..

Hope this helps..