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Sleep-Disordered Breathing in Vietnam Veterans with Posttraumatic Stress Disorder

https://doi.org/10.1097/JGP.0b013e3181e446eaGet rights and content

Objective

To study the prevalence of sleep-disordered breathing (SDB) in Vietnam- era veterans.

Methods

This was an observational study of Vietnam-era veterans using unattended, overnight polysomnography, cognitive testing, and genetic measures.

Results

A sample of 105 Vietnam-era veterans with posttraumatic stress disorder: 69% had an Apnea Hypopnea Index >10. Their mean body mass index was 31, “obese” by Centers for Disease Control and Prevention criteria, and body mass index was significantly associated with Apnea Hypopnea Index (Spearman r = 0.41, N = 97, p < 0.0001). No significant effects of sleep-disordered breathing or apolipoprotein status were found on an extensive battery of cognitive tests.

Conclusion

There is a relatively high prevalence of SDB in these patients which raises the question of to what degree excess cognitive loss in older PTSD patients may be due to a high prevalence of SDB.

Section snippets

Subjects

Community-dwelling veterans 55 years or older with PTSD of any race or ethnicity were recruited through media advertisement, local veteran agencies, clinician referral from the outpatient clinics of the VA Palo Alto Health Care System, geriatric clinics, and the National Center for PTSD branch at the Menlo Park Division of VA Palo Alto Health Care System. From these sources, 157 male subjects residing primarily in the San Francisco Bay Area received an initial screening, 123 were found eligible

RESULTS

Our subjects were primarily from the San Francisco Bay Area and of the expected demographic make-up of Vietnam-era veterans living in this region (Table 1). APOE η4 carrier status was at the expected prevalence (26% of our sample). The incidence of SDB was 69% using a criterion of AHI ≥10. As expected, body mass index (BMI) was significantly associated with AHI (Spearman r = 0.41, N = 97, p <0.0001). APOE η4 carrier status was not associated with AHI ≥10: mean (SD) AHI scores in APOE η4

DISCUSSION

Recently, a team of researchers44 found that PTSD was associated with a nearly twofold risk of developing dementia among older veterans such as veterans with PTSD had a 7-year cumulative incident dementia rate of 14.4%, whereas those without PTSD had a rate of 8.1%. Using age as the time scale and adjusting for demographics, medical, and psychiatric comorbidities, patients with PTSD were nearly twice as likely to develop incident dementia (hazards ratio: 1.93, 95% confidence interval:

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    The authors acknowledge the efforts of Emily Luther, Kader Ucar, and Claire Stewart for their assistance with study coordination and data collection.

    This research was supported by the Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MI- RECC) and the Medical Research Service of the Department of Veterans Affairs. Dr. David's contribution was also supported by an Alzheimer disease Plan grant from the Conseil General des Alpes-Maritimes, Nice, France.

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