Ptsd And Sleep Apnea: The Basics
Sleep apnea is a condition responsible for people having difficulty breathing during the night. Often it is discovered through symptoms like snoring and trouble sleeping. Sleep apnea can be a mild condition managed with lifestyle changes, or a very serious concern.
Currently, sleep apnea affects around 22 million Americans, though there may be even more people who have no idea theyre suffering from the condition.
Sleep apnea can be worsened or triggered by various factors, including age, the consumption of alcohol, smoking, poor eating habits, unhealthy eating patterns, lack of physical activity, and the use of medications.
So, can PTSD cause sleep apnea?
Post traumatic stress disorder, or PTSD, is a mental health issue that occurs following a traumatic event. Experts say up to 8% of the population will experience PTSD at some point in their lives.
People with this issue will experience various symptoms. Some have trouble eating, memory problems, or feel excessive anxiety. Sleep problems and insomnia are also common.
Emerging research suggests a strong connection between people with sleep apnea, and those with PTSD. Particularly, the connection seems to exist mostly between Obstructive Sleep Apnea and PTSD.
Can Sleep Apnea Cause Anxiety
Sleep apnea is one of the most terrifying conditions and this is chiefly because, as a sleep disorder, it is something that the sufferer is totally powerless against. The nature of the condition makes the fear of complications both while asleep and to long-term health so severe that many people who suffer from this condition dont only face the terrible reality of the condition itself, but the near-constant fear and anxiety of a potential attack occurring while asleep.
When it comes to sleep, its one of the most important bodily functions, and scientists believe that even slight irregularities in sleep routines and sleep quality can have far reaching and long-term effects on our health.
Those who suffer from sleep apnea face all of these problems, and many others besides, meaning that those who suffer from sleep apnea are much more likely to be prone to poor health and other concerns such as anxiety and even depression as a result of poor sleep quality.
One of the main tragedies of this fact is that it isnt very well known, and many people dont understand how life changing a diagnosis of sleep apnea can be, and how difficult it can be to have your sleep become a worrisome and potentially fatal experience that you may never wake up from.
These devices have helped to massively improve the quality of life for people with this condition, however, many people still suffer from the terrible fear that comes with this condition.
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Sleep Apnea Must Be Service
One main reason why veterans repeatedly get denied by the VA is that they submit their sleep apnea claim with no clear evidence of service-connection. What does that mean?
As the phrase implies, Service-connected means that the disability aggravated while in service. If you were diagnosed while in the service, and you have consistent documentation, then you have a better chance of getting a service-connection. Unfortunately, there arent a lot of cases where sleep apnea is commonly diagnosed in the service.
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Woods & Woods Va Disability Lawyers Can Help With Your Ptsd And Sleep Apnea Application For No Charge
The Veterans Disability Benefits Lawyers at Woods and Woods recognize the difficulties that accompany applying for veterans disability benefits based on conditions caused by PTSD. Thats why were here to answer any questions you may have if you are considering applying for benefits or have had a claim for benefits denied in the past. Was your PTSD claim denied? We can help with that too! Call us toll-free at 232-5777.
Anxiety Depression And The Brain Detox
So why is there such a strong connection between insomnia, anxiety and depression?
Part of the answer to that question became clearer in 2013 when it was discovered that during deep sleep, our brain goes into a literal rinse-cycle or a deep clean. This miraculous event is able to happen because as we sleep brain cells shrink by up to 60%, creating space between the cells to literally flush away debris in the cerebrospinal fluid and out of the brain. OUR BRAINS DETOXIFY AS WE SLEEP. We are simply not going to feel refreshed and ready to take on the new challenges of a new day in the same way if we do not sleep well.
We feel fatigued when we dont sleep and a feeling of fatigue can lead to a low mood. We may feel more anxious too because we feel less able to face the challenges ahead of us. We may feel more anxious and low because we feel alone in the vulnerability caused by lack of sleep. We need to feel strong in order to not feel helpless.
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How Are Ptsd And Sleep Apnea Connected
So, we know that sleep problems are frequently linked to post-traumatic stress disorder. But whats the specific connection between PTSD and sleep apnea?
As we pointed out in our blog post exploring the connection between anxiety and sleep apnea, a 2015 study in the Clinical Psychology Review considered the presence of sleep apnea to be a risk factor for PTSD.
Insomnia and excessive daytime sleepiness even within a month after a traumatic event are important predictors for the development of PTSD, the report claims. One specific sleep disorder sleep apnea may even intensify symptoms of PTSD, including sleeplessness and nightmares.
PTSD and sleep apnea share other connections. In a sample of 78 individuals seeking treatment for posttraumatic sleep disturbances 95% of those tested experienced diminished airflow during sleep which is suggestive of sleep-disordered breathing , according to the authors of a 2012 study published in the Journal of Clinical Sleep Medicine.1
That same study found that, among 44 consecutive crime victims with PTSD reporting nightmares and insomnia, 91% also had sleep-disordered breathing .
Untreated OSA appears to be associated with worse outcomes among patients with PTSD, the authors continued. Likewise, CPAP therapy has been shown to improve symptoms of depression among patients with concomitant PTSD.
What Does Anxiety Feel Like
The symptoms of anxiety disorders can affect people both emotionally and physically.
People with anxiety may feel extremely nervous and on-edge. This can affect their concentration and mood, leading to irritability and restlessness. Their fear or sense of impending doom can feel overwhelming and out-of-control.
Physically, anxiety disorders can provoke tense muscles, rapid breathing and heartbeat, sweating, trembling, gastrointestinal distress, and fatigue.
Many people with anxiety disorders attempt to avoid situations that could trigger heightened worry however, this does not resolve their underlying fear and can interrupt both professional and personal activities. Over time, a person with anxiety disorder may get used to being worried such that a state of distress or fear seems normal.
Anxiety disorders can occur alongside other mental health problems like depression. According to the Anxiety and Depression Association of America , nearly 50% of people with depression are also diagnosed with an anxiety disorder.
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How Do Sleep Issues Affect Ptsd Symptoms
Among people who experience a traumatic event, those who suffer significant sleep problems appear to be more likely to develop PTSD in the future. In fact, one of the earliest signs of PTSD is sleep disturbance, which often encompasses nightmares, insomnia, and fragmented rapid eye movement sleep.
Interestingly, sleep problems that precede the traumatic event may also play a role. One study found that people reporting nightmares before going to war were more likely to develop PTSD after coming back.
Once the disorder sets in, the presence of sleep problems appears to exacerbate PTSD symptoms. And even after treating daytime PTSD symptoms, many people find that insomnia still persists.
Sleep problems in PTSD interfere with the brains ability to process memories and emotions, slowing down the recovery process after a traumatic event. Moreover, many people with PTSD use alcohol or other substances to try to sleep better. Far from helping, these counterproductive coping mechanisms actually worsen sleep and can aggravate PTSD symptoms as well.
Treating Sleep Apnea In Nashville
Both of the dentists at Devine Dentistry can perform an airway evaluation to detect the presence of a sleep breathing disorder such as sleep apnea. From there, we can treat your disorder by addressing the root causewhatever is blocking your airwaythrough oral appliance therapy. Drs. Brian Devine and Russell Mack can provide you with a custom-made mouthpiece, made from high-quality materials and designed for a snug, comfortable, and effective fit in your mouth. When worn, one of our oral appliances guides your lower jaw forward, helping you maintain an open airway all night long.
Anxiety and depression can ruin your life. So can sleep loss. If youre getting proper rest, you have a better chance of overcoming your anxiety disorder and reclaiming the life you want. Get screened for a sleep breathing disorder today by calling the office of Devine Dentistry today at 269-4209 if you live in the areas of Belle Meade, Green Hills, and Nashville, TN.
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Negative Thoughts And Feelings
PTSD is sometimes treated with a toxic blame the victim mentality. The disability is often handled poorly by a sufferers friends and family, making a Veteran with PTSD feel responsible for their trauma. However, PTSD is not a weakness, nor is it something that anyone should blame themselves for. Nevertheless, many Veterans with PTSD feel intense guilt and shame related to their condition.
How Does Ptsd Affect Sleep
Individuals with PTSD frequently have trouble falling asleep and awaken easily, often waking up many times throughout the night. Many people with PTSD also have nightmares. These issues result in disrupted, non-refreshing sleep.
Those with chronic pain, substance abuse, traumatic brain injury, depression, or other medical problems face an additional barrier to getting quality sleep. Certain sleep medications also interfere with REM sleep, which is the sleep stage during which we dream and an important sleep stage for dealing with traumatic memories.
The most common sleep problems in PTSD can be summed up in three categories:
Treating PTSD-related sleep problems, as well as co-existing disorders such as depression, is an important part of resolving overall PTSD symptoms.
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Treating The Sleep Problems Of Ptsd
It is important to be treated for both PTSD and the sleep problems it causes. That is because a lack of sleep can make PTSD symptoms worse in the daytime. The sleep problems of PTSD can also make physical pain worse, increase blood pressure, and lead to obesity.1-4
Cognitive behavioral therapy for insomnia is one of the key non-drug ways to treat the sleep problems of PTSD, especially insomnia. CBT-I basically teaches someone about healthy sleep habits and coaches them on ways to deal with nightmares. It also includes relaxation exercises and positive self-talk. People with PTSD and sleep apnea are treated with a CPAP machine.1-4,9
Medication You Take For Ptsd Depression And Other Mental Health Disorders
Sleep apnea is NOT a presumptive condition You must have a nexus from your doctor first with a good rationale before you even file this claim.
You need to address this claim right from the start, if you have other issue at you are rated for at can also cause or add to the cause of sleep apnea you combin them all togather.
Read the guide on secondary service conection and than look at the one example of the NOD using the Sleep apnes. If you have an issue of chronic pain in your legs and not able to walk long and you are on pain and other meds for it, you add that into the claim too. You would not just the meds for the PTSD but everything you are rated for when you file.
Preparing your claim
A claim for veterans disability compensation on sleep apnea, secondary to medication taken for the treatment of PTSD and or other mental health disorders, should have all elements completed before you file.
You will be filing a Fully Developed Claim with your VA Regional Office . This allows them to process your claim faster. However, if any evidence is missing, no matter what the reason, it will be left out of consideration when your FDC is reviewed to make a decision. You can tell the VARO that you have more eveidence and this will now take your claim out of the FDC track and slow it down.
Preparing for your examination by a doctor
Here is a checklist of things you will want to bring with you and show your doctor:
Get someone in your corner when you appeal
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How To Sleep Better With Ptsd
Elements of proper sleep hygiene can go a long way toward reducing PTSD sleep problems. These include:
- Keeping a cool, dark, and quiet sleep environment
- Reserving the bedroom for sleep and sex only
- Staying on a regular bedtime schedule
- Eating a healthy diet and avoiding caffeine before bedtime
- Getting regular exercise, which also helps tame hyperarousal
- Avoiding stressors before bedtime, including talking about your traumatic event
- Having a warm bath or reading a calming book before bedtime
- Turning off screens an hour before bedtime
- Using a white noise machine if you are sensitive to sounds
- Using meditation or other techniques to prevent rumination
You should sleep in a room that makes you feel safe, which may or may not be your bedroom. If you are uncomfortable sleeping in a dark room, a nightlight may provide a feeling of security.
People with PTSD are often afraid to go to sleep because they worry they will have nightmares. Unfortunately, this can lead to spending hours in bed with racing thoughts. If you have been in bed for 20 minutes and you cant fall asleep, get out of bed, go to another room to do something relaxing, and only return to bed when you feel sleepy. This will help strengthen the mental association between your bed and sleep.
Vets With Ptsd And Sleep Apnea Less Likely To Use Cpap
Posttraumatic stress disorder in returning combat veterans with comorbid obstructive sleep apnea is associated with significantly worse continuous positive airway pressure adherence compared to a similar population of patients without PTSD, according to a new study.
Current combat veterans are a particularly vulnerable population due to psychiatric diseases such as PTSD, depression and anxiety, substance use, traumatic brain injuries and multiple injuries often associated with disability and chronic pain, said lead author Jacob Collen, MD, Maj., MC, U.S. Army, Pulmonary, Critical Care and Sleep Medicine fellow at Walter Reed National Military Medical Center in Bethesda, Md. Sleep disordered breathing is highly prevalent and has been demonstrated to worsen outcomes in patients with psychiatric disease, and prior, smaller studies have demonstrated that CPAP therapy may improve outcomes in patients with PTSD and obstructive sleep apnea.
The study, which will appear in the December 15, 2012 edition of the Journal of Clinical Sleep Medicine, involved 90 patients with newly diagnosed OSA who initiated CPAP therapy . Results show that regular use of CPAP was significantly less common among patients with PTSD and was observed in 25.2 percent, compared with 58.3 percent among patients without PTSD. Greater adherence with CPAP was observed among patients with PTSD who were chronically using sedatives.
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What If You Conducted The Study After You Separated Or Retired
Most veterans fall in the category of conducting a sleep study when they got out , and it was evident by the doctor that you had sleep apnea and had a CPAP machine. Acquiring a CPAP machine still does not constitute an automatic claim approval. On the bright side, since the VA provided the CPAP machine, that means its in your medical records.
Your medical records are essential in all of your claims. Especially when it comes to sleep apnea, a complex process where most of the information will depend on how well its been service-connected.
How Can Healthier Sleep Habits Treat Sleep Anxiety
Sleep habits, or sleep hygiene, are your routines around bedtime that can affect your sleep. Your healthcare provider may ask you to keep a sleep diary for several weeks. This is a daily log of your sleep habits. It can help identify things that might make it harder for you to fall asleep or stay asleep.
Some common ways to improve your sleep hygiene include:
- Avoid drinking lots of fluids before bed, especially alcohol.
- Do relaxing activities before bed, such as meditation or listening to soft, peaceful music.
- Dont consume caffeine in the late afternoon or evening.
- Dont go to bed unless you feel sleepy.
- Go to bed and wake up at the same time each day.
- If you dont fall asleep within 20 minutes, get out of bed.
- Make sure your bedroom is comfortable, quiet and softly lit.
- Only use your bed for sleep and sex. For example, avoid watching television or doing work in bed.
- Set a goal of getting at least seven hours of sleep every night.
- Stop using electronic devices at least 30 minutes before bedtime.
- Try not to eat right before bedtime. If youre hungry, have a light snack and not a big meal.
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Headaches Secondary To Sleep Apnea
Migraines are recurring, incredibly painful, and often highly debilitating headaches. These can cause disturbances in ones daily life and their ability to do work to the highest degree. A migraine can often leave its victim incapacitated from pain and hypersensitivity and largely unable to move. These are very painful experiences and can often bring a whole host of other side effects, including nausea, weakness, and extreme sensitivity to light and sound. It can be very difficult to function as a victim of chronic migraines, and it is essential to try and find the cause and solution to the migraines as fast as possible.
The American Migraine Foundation has reported that people with migraines are between 2 and 8 times more likely to experience sleep disorders than the general public. This means that people who struggle with sleep disorders and sleep apnea have a higher risk of chronic migraines, which would potentially account for a secondary basis in the eyes of the Department of Veterans Affairs. Its critical for Veterans who need help to reach out to the VA and see if their condition is worth disability compensation for the toll that migraines can take when at work.