When Traumatic Memories Affect Your Health: A Clinical Case Study

Abstract

Obstructive sleep apnea hypopnea (OSA) is the most common breathing-related sleep disorder and affects more than 20% of older individuals. Furthermore, risk of OSA increases in postmenopausal women. OSA is effectively treated using continuous positive airway pressure (CPAP). However, Mary, a 74-year-old White woman with OSA, severe, refused to obtain a CPAP machine because the sound of the machine elicited memories of her late husband’s suicide. Intervention focused on reducing Mary’s fear of CPAP sounds. Treatment involved imaginal exposure, in vivo exposure, sleep hygiene strategies, and relaxation strategies. Although evidence-based treatments for OSA and trauma separately exist, there are no treatment protocols designed to address the specific combination of the conditions. Treatment gains included a reduction in trauma-related symptoms and an increase in CPAP compliance. Quantity and quality of patient’s sleep did not improve despite sleep hygiene and CPAP use. At 3-week follow-up, treatment gains and CPAP compliance were maintained.