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Can Trauma Cause Sleep Apnea

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Sleep Apnea Secondary To Ptsd

Screening Patients with Traumatic Brain Injuries for Sleep Apnea

An increasing number of scientific studies show that sleep apnea and PTSD are comorbid conditions. One study compared the records of 4 million Veterans who have PTSD and those not who have PTSD to find a connection between PTSD and sleep apnea. They found an incredible statistical difference. Approximately 11.85% of individuals who have PTSD also had sleep apnea. This is a relatively significant difference when you compare it to the 4.74% of individuals with sleep apnea who do not have PTSD.

Thus, according to the study, individuals with PTSD are 2.7 times more likely to suffer from sleep apnea than those without PTSD. This means Veterans are at a higher risk of having sleep apnea secondary to PTSD. This statistic does not verify that a Veterans sleep apnea is secondary to PTSD, but it is still helpful. To get service connected, a Veteran will need to provide the VA with medical records and other information to verify that the two conditions are directly linked.

In addition, other studies also came to the same conclusion as the previously mentioned study. Researchers at Walter Reed Army medical center looked at sleep problems among 80 OIF/OEF Veterans returning from combat diagnosed with PTSD. Almost all of them said they had problems sleeping, and almost two-thirds suffered from sleep apnea. This is substantial compared to the American frequency of 20% of men and 9% of women who have had sleep apnea at some time in their lives.

Tips For Sleeping After Trauma

Its normal for a traumatic experience to affect the quantity and quality of your sleep. Be patient with yourself and try to have realistic expectations about the time it will take for your body to heal. Working with a doctor, psychologist or counselor can help you create reasonable, achievable goals for coping with sleep issues after trauma. Here are a few other tips for sleeping as you heal from trauma:

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How Can You Receive Va Disability For Sleep Apnea

Sleep apnea is a common condition that affects about 22 million people nationwide. If you are among the former military service members living with sleep apnea, you may be eligible for veterans disability compensation. This guide will outline the basics of sleep apnea, how the VA disability rating works for this condition, and how qualifying veterans can prove service connection.

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Ptsd Severity Linked To Higher Risk Of Sleep Apnea In Veterans

HealthDay News For U.S. veterans with post-traumatic stress disorder , the risk of sleep apnea increases along with the severity of the mental health condition, a new study contends.

Sleep apnea a common sleep disorder in which breathing frequently stops and starts is potentially serious.

Researchers looked at 195 Iraq and Afghanistan veterans who visited a Veterans Affairs outpatient PTSD clinic for evaluation. About 69% were at high risk for obstructive sleep apnea, and the risk rose along with PTSD symptom severity, the study authors said.

PTSD symptoms can include intrusive memories and nightmares, negative changes in mood and heightened emotional reactivity.

Every clinically significant increase in PTSD symptom severity was associated with a 40% increase in being at high risk for sleep apnea, according to the study published in the May issue of the Journal of Clinical Sleep Medicine.

The implication is that veterans who come to PTSD treatment, even younger veterans, should be screened for obstructive sleep apnea so that they have the opportunity to be diagnosed and treated, co-principal investigator Sonya Norman, a researcher at the San Diego VA, said in a news release from the American Academy of Sleep Medicine.

The link between sleep apnea and PTSD in veterans is not clear. Possible factors that may connect the two disorders include combat-related sleep disturbances, chronic stress from PTSD, and poor sleep caused by sleep apnea, the researchers suggested.

Sleep Problems In Ptsd

Can Untreated Sleep Apnea Damage Your Health?

People with PTSD may experience a number of different types of sleep problems. Many people with PTSD have difficulties falling asleep as compared to people without PTSD. In fact, one study of Vietnam veterans found that 44% of those with PTSD said that they have trouble falling asleep at night, whereas less than 10% of combat veterans without PTSD said that they have this problem.

People with PTSD may wake up frequently during the night, have difficulty falling back asleep, or may wake up earlier than they intended. Also, even if sleep does occur, it is often not good, restful sleep.

Of course, nightmares are also very common among people with PTSD. Nightmares are considered one of the re-experiencing symptoms of PTSD. Among people with PTSD, nightmares may be about the traumatic event a person experienced or they may be about some other upsetting or threatening event.

Finally, because of these sleep problems, people with PTSD often develop fears about going to sleep. They may experience worries or thoughts about their traumatic event as soon as they go to bed. They may also fear acting out their nightmares while asleep or impulsively upon being woken up from a nightmare, leading them to sleep alone away from their partners.

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There Is Growing Understanding Of The Relationship Between Trauma And Sleep

Posted June 29, 2016

In the last post I discussed the impact of traumaticstress on sleep. In this post I will discuss in greater detail the ways in which traumatic stress affects sleep and how sleep disorders interact with the effects of traumatic stress.

Traumatic stress can negatively impact sleep in many ways. People who have had traumatic experiences often display hypervigilance, a state of heightened awareness in order to guard against further harm. This high level of arousal makes it extremely difficult to relax and fall asleep.

Traumatic events occur during the night as well as during the day, and this can cause fear conditioning to the presence of darkness. Some patients fear falling asleep and have a vague sense of foreboding as they prepare for bed. With further reflection it sometimes emerges that this fear is a conditioned response to being especially vulnerable during the night, when they experienced physical or sexual abuse as a child. One of my supervisors in graduate school had been in Vietnam during the Tet Offensive of 1968 and had experienced extreme violence during the night. Even 10 years later he found it virtually impossible to sleep at night due to the constant fear associated with the onset of darkness. He could only sleep as the morning came or if a friend were available to stay awake and stand guard.

Ptsd And Sleep Apnea: Does Ptsd Cause Sleep Apnea

The connection between PTSD and sleep apnea is a growing area of study.

Sleep apnea is among the most worrying conditions a person can have, as it involves the inability to breathe properly during periods of sleep.

There are different kinds of sleep apnea, including obstructive sleep apnea . You could also suffer from central or mixed sleep apnea.

Reasons for the development of sleep apnea are difficult to pin down, but doctors have linked everything from obesity to muscle issues to the condition. Now, it appears PTSD and sleep apnea may also be linked.

Today, were going to look at the connection between PSTD and sleep apnea, and what people can do if they believe both of these conditions are affecting them in tandem.

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Treating Sleep Apnea And Ptsd

Because difficulty sleeping is a common arousal symptom of PTSD, better sleep hygiene is often part of the PTSD treatment plan, along with talk therapy and medication. Doctors may recommend following a strict sleep schedule, adopting a calming bedtime routine to relieve stress, and reducing caffeine and alcohol intake.

Sleep apnea is most commonly treated with a weight loss program or weight loss surgery for those who are overweight, and continuous positive airway pressure therapy. In CPAP therapy, Individuals sleep with a mask that connects via a hose to a CPAP machine on their bedside table. CPAP therapy enables the persons airways to stay open during sleep, reducing apnea episodes during the night.

Fortunately, the evidence suggests that for individuals with sleep apnea and PTSD, consistent CPAP therapy can not only relieve symptoms of sleep apnea, but also those of PTSD, including anxiety, depression, nightmares, and quality of life. Unfortunately, the reverse is also true: untreated OSA is associated with poorer outcomes for PTSD.

Diagnosing And Treating Sleep Apnea

Trauma, Anxiety & Sleep Disturbances

Sleep apnea needs to be diagnosed with a sleep study performed by a qualified healthcare provider. The test, also known as a polysomnogram, is typically done at a sleep center but can be conducted at home for some individuals.

Some common signs that suggest a person may suffer from sleep apnea include:

  • Loud snoring
  • Waking up with a sore throat and dry mouth
  • Insomnia
  • Recurring waking throughout the night
  • Waking up with a choking or gasping sensation
  • Sleepiness or lack of energy during the day
  • Difficulty with concentration and memory during the day

Sleep apnea can be treated in a variety of ways. A Continuous Positive Airway Pressure machine is often recommended to deliver a constant flow of air into the nose to keep the airways open during sleep. Surgery helps in some cases, and lifestyle modifications such as losing weight or quitting smoking may also be recommended.

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Sleep Tips For Partners Of People With Ptsd

While most efforts are focused on how to help someone with PTSD sleep, the partners of people with PTSD may also find it difficult to sleep soundly. For those with a partner who wakes up multiple times during the night, it may help to invest in a mattress that muffles sound and movement.

Nightmares and night terrors can be frightening and may cause your partner to lash out violently. Though you want to be there for your partner, you may find it necessary to sleep in a separate, nearby bedroom from time to time so you can get the restful sleep you need.

It may also be constructive to do exercise together with your partner during the day. In addition to improving sleep, developing healthy routines together can help you bond and help re-establish a sense of security for your partner.

Many caregivers struggle with feelings of guilt and a sense that they are responsible for saving their partner. However, pouring all your energy into helping another person can have a serious effect on your own mental health. Couples therapy, individual therapy, support groups, or a strong network of family and friends may help you manage your own thoughts and feelings to reduce the risk of burnout.

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What Is A Secondary Service Connection

Secondary service connection means that a Veteran suffers from secondary basis illnesses related to their primary disability. Most mental and physical conditions can lead to other disabilities that are compensable by the VA. For example, lets say a Veteran has diabetes related to Agent Orange. The Veteran is entitled to disability compensation for diabetes. However, the Veteran may also suffer from neuropathy, which is pain and nerve damage typically caused by diabetes. Because the diabetes is causing neuropathy, the Veteran should be entitled to compensation for that as well.

Now, if a Veteran has been diagnosed with PTSD and is also displaying sleep apnea symptoms, they could receive disability compensation for both PTSD and sleep apnea. To receive compensation, the Veteran would need to prove service connection for sleep apnea secondary to PTSD.

To prove that there is a connection between sleep apnea and PTSD, a disabled Veteran will need to medically verify that their PTSD symptoms led to the development or exacerbation of sleep apnea and sleep deprivation. A Veteran may have had a sleep apnea diagnosis before being diagnosed with PTSD. However, sleep apnea can still be considered a secondary condition if the Veterans symptoms were made worse by PTSD.

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What Does Anxiety Feel Like

The symptoms of anxiety disorders can affect people both emotionally and physically.

People with anxiety may feel extremely nervous and on-edge. This can affect their concentration and mood, leading to irritability and restlessness. Their fear or sense of impending doom can feel overwhelming and out-of-control.

Physically, anxiety disorders can provoke tense muscles, rapid breathing and heartbeat, sweating, trembling, gastrointestinal distress, and fatigue.

Many people with anxiety disorders attempt to avoid situations that could trigger heightened worry however, this does not resolve their underlying fear and can interrupt both professional and personal activities. Over time, a person with anxiety disorder may get used to being worried such that a state of distress or fear seems normal.

Anxiety disorders can occur alongside other mental health problems like depression. According to the Anxiety and Depression Association of America , nearly 50% of people with depression are also diagnosed with an anxiety disorder.

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What Were The Results

Sleep Apnea Treatment &  Symptoms Bountiful UT

Screening. To identify people with TBI who were at risk for moderate to severe sleep apnea, the STOP-Bang and MAPI surveys worked about the same. STOP-Bang and MAPI worked better than the Berlin survey or wristband. To identify people with TBI who were at risk for mild sleep apnea, all three surveys worked about the same and better than the wristband.

Diagnosis. Portable equipment wasnt as good as the standard test to diagnose sleep apnea. It was less likely to detect mild sleep apnea, and it was less accurate in diagnosing sleep apnea severity for people with moderate or severe sleep apnea.

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Connecting Ptsd And Sleep Apnea

What is the relationship between obstructive sleep apnea and PTSD? Importantly, how might sleep apnea trigger increased sleep fragmentation, resulting in nightmares or insomnia, the two key sleep symptoms within the diagnostic criteria for PTSD?

Although these conditions are shared by many patients, the exact mechanism linking them is not fully understood. It is likely due to a complex interplay between sleep fragmentation and neuroendocrine pathways. As noted above, the release of cortisol associated with sleep apnea episodes may have a key role in this relationship.

It should be noted that sleep apnea is often worsened during rapid eye movement sleep. REM is when vivid dreams occur, and the muscles of the body are paralyzed so that dreams are not enacted.

This normal paralysis may also affect the airway muscles, exacerbating risk factors for sleep apnea and causing more episodes to occur. The affected person may wake gasping with associated dream recall, possibly inciting a cascade of traumatic memories.

There may be other contributing factors connecting these disorders, including:

  • Disturbed sleep in combat
  • Chronic stress
  • Coexisting mood disorders

Further research is needed to understand this complex relationship. Fortunately, effective treatment of sleep apnea may help alleviate PTSD symptoms.

Relationship Between Sleep Apnea And Ptsd

Research shows that veterans with PTSD have a higher risk of developing sleep apnea. There is also a direct correlation regarding the severity of the two conditions insofar as the more severe a veterans PTSD is, the more severe their sleep apnea will be. This is due in part to the fact that many factors that can aggravate PTSD can also aggravate sleep apnea. For example, sleep deprivation, insomnia, hyperarousal, and daytime sleepiness all affect both PTSD and sleep apnea.

If a veteran has both of these conditions, they may be entitled to VA disability benefits.

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Calculating Your Va Rating For Sleep Apnea Secondary To Ptsd

If you have more than one service-connected disability, the VA gives you a combined rating. Calculating your combined rating is a little more complicated than just adding the disability ratings together.

Lets look at an example. Amy in Orlando is rated at 50% for PTSD and 50% for sleep apnea. That gives her a 100% rating, right? Not quite. Instead of adding the ratings together , the VA uses a ratings table to find the combined rating. Consulting the ratings table, we find that combing Amys 50% PTSD and 50% sleep apnea gives her a 75% rating.

The reason the VA uses a ratings table and doesnt just add up percentages is because a person cant be more than 100% disabled. If, for example, Amy had another 50% rating for a left knee injury, her combined rating would be 88%, not 150%. For more on how VA Math works, check out our article on How to Calculate Your VA Disability Rating.

You may have heard the term VA math before. The person using the term is usually expressing confusion or frustration with the weird way the VA rates disability.

Who Was In The Study

Sleep problems in cervical instability patients: structural sleep apnea and insomnia

The comparison of diagnostic tests included 214 people receiving inpatient treatment for TBI at one of six rehabilitation centers across the country. The screening study included 248 people at these centers. Of these patients, 74 percent were White, 20 percent were Black, 13 percent were Hispanic, 3 percent were Asian, and 2 percent were another race or ethnicity. The average age was 44, and 82 percent were men 61 percent had severe TBI.

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How Do Sleep Issues Affect Ptsd Symptoms

Among people who experience a traumatic event, those who suffer significant sleep problems appear to be more likely to develop PTSD in the future. In fact, one of the earliest signs of PTSD is sleep disturbance, which often encompasses nightmares, insomnia, and fragmented rapid eye movement sleep.

Interestingly, sleep problems that precede the traumatic event may also play a role. One study found that people reporting nightmares before going to war were more likely to develop PTSD after coming back.

Once the disorder sets in, the presence of sleep problems appears to exacerbate PTSD symptoms. And even after treating daytime PTSD symptoms, many people find that insomnia still persists.

Sleep problems in PTSD interfere with the brains ability to process memories and emotions, slowing down the recovery process after a traumatic event. Moreover, many people with PTSD use alcohol or other substances to try to sleep better. Far from helping, these counterproductive coping mechanisms actually worsen sleep and can aggravate PTSD symptoms as well.

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