Detailed polysomnography in australian vietnam veterans with and without post traumatic stress disorder

Abstract

Introduction: Recent results from GMRF-PTSD-01, a cross-sectional cohort study in 214 Vietnam Veterans (VV) with and without post traumatic stress disorder (PTSD), demonstrated an increased prevalence of sleep disorders in PTSD subjects, based on selfreported questionnaires. This study aims to objectively assess the prevalence and severity of both sleep disordered breathing and periodic limb movements (PLM) using detailed polysomnography (PSG) in VV with and without PTSD. Methods: Participants from GMRF-PTSD-01 were recruited to undergo detailed PSG. PTSD status was confirmed using the clinician administered PTSD scale (CAPS-5). Supervised questionnaires including Epworth Sleepiness Scale (ESS), Berlin and Mayo, self reported restless legs, and alcohol use (AUDIT) were attained. Detailed PSG data including sleep architecture, body position, respiratory and arousal indices, periodic limb movements and cardiovascular parameters were collated. Statistical analysis directly comparing the PTSD and non-PTSD cohorts was undertaken. Results: Seventy-four VV (all male; 40 with PTSD) underwent detailed PSG, 59 prospectively. No difference in age, BMI, ESS, or AUDIT was seen. VV with PTSD had significantly higher Berlin scores (69.2% vs. 38.2%; p < 0.01) and higher rates of reported restless legs (41% vs. 20.6%; p = 0.06) and limb movements (55% vs. 17.6%; p < 0.01). Based on respiratory disturbance index, no difference was seen in obstructive sleep apnoea (OSA) prevalence or severity, however VV with PTSD had an increased duration of sleep with oxygen saturations (SpO2) < 90% (10.2% vs. 1.8%; P = 0.02). Other respiratory indices, SpO2 nadir, sleep architecture, EEG arousals, PLM, mean heart rate and blood pressure were similar between groups. Discussion: In VV with and without PTSD, apart from duration of sleep with SpO2 < 90%, no difference was seen in the prevalence and severity of OSA, PLM, and other PSG parameters. Moreover, VV with PTSD demonstrated an increased perception of sleep disorders. Exploration into these objective and subjective discrepancies is warranted in order to better understand and manage individuals with PTSD, particularly in the veteran population.L619526021 <br />