The effect of continuous positive air pressure (CPAP) on nightmares in patients with posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA)

Tamanna, Sadeka; Parker, Jefferson D.; Lyons, Judith; Ullah, M. I.

doi:10.5664/jcsm.3786

Cited by 75Obstructive Sleep Apnea ResearchSleep and related disordersPosttraumatic Stress Disorder Research

The effect of continuous positive air pressure (CPAP) on nightmares in patients with posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA)

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Tamanna, Sadeka, Parker, Jefferson D., Lyons, Judith, Ullah, M. I.·2014·Journal of Clinical Sleep Medicine

DOI 10.5664/jcsm.3786PMC PMC4031403

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Abstract

Objectives Post-Traumatic Stress Disorder (PTSD) is increasingly prevalent among Veterans characterized by recurrent nightmare and disrupted sleep. Veterans with PTSD also have a high prevalence of obstructive sleep apnea (OSA) and untreated OSA worsens the sleep-related symptoms of PTSD. In our study, we hypothesized that among PTSD-afflicted Veterans with OSA, CPAP therapy may reduce the frequency of nightmares and a better CPAP compliance may be associated with increased symptom improvement. Methods We retrospectively reviewed medical records to identify OSA patients treated in a VA medical center who also carried a diagnosis of PTSD (n = 69). Data about patient characteristics and polysomnographic findings were extracted. Repeated-measures t-tests were performed, comparing mean nightmare frequency and Epworth sleepiness score (ESS) before and after CPAP treatment. Multiple linear regressions were done to identify factors predicting CPAP compliance. A logistic regression analysis was also done to estimate the odds of subjective improvement in PTSD symptoms with CPAP. Results CPAP therapy reduced the mean ESS from 14.62 to 8.52 (p < 0.001) and the mean number of nightmares per week from 10.32 to 5.26 (p < 0.01). Reduced nightmare frequency after CPAP treatment was best predicted by CPAP compliance (p < 0.001). Every 10% increase in CPAP compliance almost doubled the odds of benefitting by CPAP (odds ratio = 1.92, 95% CI = 1.47-2.5). Conclusions In Veterans with PTSD and OSA, CPAP therapy reduces PTSD-associated nightmares and improves overall PTSD symptoms. We recommend that all PTSD patients should be screened clinically for symptoms of OSA and receive CPAP treatment whenever possible to improve PTSD symptoms.

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Nightmares are more frequent when patients are sleep deprived.
“as previous studies demonstrate that nightmares are more frequent when patients are sleep deprived (Creamer, Brock, Matsangas, Motamedi, & Mysliwiec, 2018; Tamanna, Parker, Lyons, & Ullah, 2014).”
From Benefits of Cognitive Behavioral Therapy for Insomnia for Women Veterans with and without Probable Post-Traumatic Stress Disorder (2022) · cites this paper as Tamanna, Parker, Lyons, & Ullah, 2014
The Discussion (page not provided) reports that interrupted sleep at night predicted nightmares in patients with obstructive sleep apnea. The Results (page not provided) also show fewer nightmares after CPAP treatment in veterans with PTSD and sleep apnea. Neither passage establishes that nightmares are more frequent when patients are sleep deprived specifically; that extends the finding beyond the conditions studied. (LLM, conf=0.82)
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Reduced nightmares per week may be related to increased total sleep time.
“Reduced nightmares per week may be related to increased total sleep time, as previous studies demonstrate that nightmares are more frequent when patients are sleep deprived (Creamer, Brock, Matsangas, Motamedi, & Mysliwiec, 2018; Tamanna, Parker, Lyons, & Ullah, 2014).”
From Benefits of Cognitive Behavioral Therapy for Insomnia for Women Veterans with and without Probable Post-Traumatic Stress Disorder (2022) · cites this paper as Tamanna, Parker, Lyons, & Ullah, 2014
The Results report fewer nightmares per week after CPAP treatment, and the introduction notes that people with PTSD have shorter total sleep time than those without PTSD. Neither passage links the reduction in nightmares to increased total sleep time or demonstrates that sleep deprivation makes nightmares more frequent. (LLM, conf=0.84)
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Clinical neurophysiology of REM parasomnias
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Authors: Tamanna, S., Parker, J. D., Lyons, J., & Ullah, M. I.
Affiliations: University of Mississippi Medical Center (US)
G.V. (Sonny) Montgomery VA Medical Center (US)
Corresponding author: Ullah, M. I.
ORCID: Parker, Jefferson D.
Venue: Journal of Clinical Sleep Medicine
Publisher: Springer Science and Business Media LLC
Published: 2014-06-15
Volume: 10
Issue: 6
Pages: 631-636
ISSN: 1550-9389 (ISSN-L)
1550-9397
DOI: 10.5664/jcsm.3786
PMC: PMC4031403
OpenAlex: W2027853831
Cited by: 75
References: 38
Citations by year: 2026: 3 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 8 · 2021: 6 · 2020: 5 · 2019: 9 · 2018: 9 · 2017: 13 · 2016: 7 · 2015: 4 · 2014: 3
FWCI: 6.00
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Journal of Clinical Sleep Medicine (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords: continuous positive airway pressure, nightmares, post-traumatic stress disorder, obstructive sleep apnea, veterans, CPAP adherence, daytime sleepiness, Epworth Sleepiness Scale, comorbid sleep disorders
MeSH terms: Dreams, Female, Humans, Male, Middle Aged, Patient Compliance, Retrospective Studies, Sleep, REM, Stress Disorders, Post-Traumatic, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

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The effect of continuous positive air pressure (CPAP) on nightmares in patients with posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA)

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