Obstructive Sleep Apnea In Veterans Research Articles

Insomnia Severity, Subjective Sleep Quality, and Risk for Obstructive Sleep Apnea in Veterans With Gulf War Illness.

Despite the fact that sleep disturbances are common in veterans with Gulf War Illness (GWI), there has been a paucity of published sleep studies in this veteran population to date. Therefore, the present study examined subjective sleep quality (assessed with the Pittsburgh Sleep Quality Index), insomnia severity (assessed with the Insomnia Severity Index), and risk for obstructive sleep apnea (assessed with the STOP questionnaire) in 98 Gulf War veterans. Veterans with GWI, defined either by the Kansas or Centers for Disease Control and Prevention criteria, had greater risk for obstructive sleep apnea (i.e., higher STOP scores) than veterans without GWI. This difference persisted even after accounting for potentially confounding demographic (e.g., age, gender) and clinical variables. Veterans with GWI, defined by either the Kansas or Centers for Disease Control and Prevention criteria, also had significantly greater insomnia severity and poorer sleep quality than veterans without GWI (p < 0.05), even after accounting for potentially confounding variables. Furthermore, there were significant, positive correlations between insomnia severity, subjective sleep quality, and GWI symptom severity (p ≤ 0.01). In stepwise linear regression models, insomnia severity significantly predicted GWI status over and above demographic and clinical variables. Together these findings provide good rationale for treating sleep disturbances in the management of GWI.

Screening for Obstructive Sleep Apnea in Veterans With Ischemic Heart Disease Using a Computer-Based Clinical Decision Support System

Screening for Obstructive Sleep Apnea in Veterans With Ischemic Heart Disease Using a Computer-Based Clinical Decision Support System

Screening for obstructive sleep apnea in veterans with ischemic heart disease using a computer-based clinical decision-support system

To assess the validity of a handheld clinical decision-support system (CDSS) in detecting obstructive sleep apnea (OSA) in veterans with ischemic heart disease against polysomnography (PSG) and to compare the diagnostic accuracy of the CDSS versus the Berlin questionnaire. We enrolled prospectively 143 patients with underlying ischemic heart disease. Veterans with history of neurologic disease, systolic congestive heart failure, or receiving opiates were excluded from participation. Participants were asked to complete the Berlin Questionnaire and to answer all eight questions of CDSS-software. At the end of the interview, veterans were scheduled for an in-laboratory polysomnogram. Ninety one patients completed the study. The prevalence of OSA (AHI ≥5/h) was 74.7% with a median AHI of 11.5/h (range 0-90). When compared to PSG, the CDSS and the Berlin questionnaire achieved a sensitivity of 98.5% [95% confidence interval (CI) 92.1-100] and 80.9% (95% CI 69.5-89.4) and a specificity of 86.9% (95% CI 66.4-97.2) and 39.1% (95% CI 19.7-61.5) at a threshold value of AHI ≥5 with a corresponding area under the curve of 0.93 (95% CI 0.85-0.97) and 0.60 (95% CI 0.49-0.70); respectively. CDSS is a superior screening tool for identifying cardiac veterans with undiagnosed OSA than the BQ.

Treatment of Obstructive Sleep Apnea may be an Important Adjunct to Therapy of Posttraumatic Stress Disorder not to be Overlooked

Treatment of Obstructive Sleep Apnea may be an Important Adjunct to Therapy of Posttraumatic Stress Disorder not to be Overlooked