Abstract 12211: Relation of Sleep Disturbances With Coronary Atherosclerosis in Posttraumatic Stress Disorder
Background: We previously reported a relation of posttraumatic stress disorder (PTSD) with subclinical atherosclerosis. PTSD sleep disturbances (i.e. nightmares and insomnia) are hallmark of PTSD symptoms and are directly involved in PTSD-relevant emotion and memory processes. This study investigated the relation of sleep disturbances measured by polysomnography with coronary atherosclerosis measured by coronary artery calcium (CAC) in PTSD.
Methods: Five hundred fifty five veterans without known CAD (58±11 years of age, 86% men) underwent CAC scanning and overnight polysomnography for clinical indications and their psychological health status (PTSD vs. non-PTSD) was evaluated. Conditional logistic regression was employed to assess the relation of apnea hypopnea indices, non-rapid (NREM) and rapid (REM) eye movement sleep phases with PTSD.
Results: REM and total apnea hypoapnea indices (AHI) as well as CAC were significantly higher in PTSD as compared to No-PTSD subjects (P=0.001). Regression analyses revealed a significant linkage between CAC>0 and PTSD and between sleep apnea and PTSD which was proportionally increased with the severity of sleep apnea (figure). After adjustment for risk factors, relative risk (RR) of CAC>0 and AHI>5 was 1.70 (95%CI 1.35 - 2.13, p=0.001) in PTSD subjects as compared to those without PTSD. REM sleep duration was significantly less with PTSD especially in those with CAC>0(figure). The relative risk of CAC>0 and decreased REM was 2.46 (95%Ci 1.92 - 3.26, p=0.001) in PTSD as compared to No-PTSD subjects.
Conclusion: There is: 1) a significant association between presence/severity of AHI and presence of CAC with PTSD, and 2) significant linkage between decrease in REM and presence of CAC with PTSD independent of age, gender, and conventional risk factors.
- © 2013 by American Heart Association, Inc.