Adherence to positive airway pressure therapy in U.S. military personnel with sleep apnea improves sleepiness, sleep quality, and depressive symptoms

Mil Med. 2015 Apr;180(4):475-82. doi: 10.7205/MILMED-D-14-00197.

Abstract

Objectives: Obstructive sleep apnea (OSA) is frequently diagnosed in U.S. military personnel. OSA is associated with sleepiness, poor sleep quality, and service-related illnesses of insomnia, depression, post-traumatic stress disorder, and traumatic brain injury.

Methods: Observational study of active duty military personnel with OSA and adherence to positive airway pressure (PAP) assessed with smart chip technology.

Results: 58 men with mean age 36.2 ± 7.7 years, mean body mass index 31.4 ± 3.7 with mean apnea-hypopnea index (AHI) 19.1 ± 19.0 are reported. 23 (39.7%) participants were adherent to PAP, and 35 (60.3%) were nonadherent. No significant differences in baseline demographics, apnea-hypopnea index, service-related illnesses, or clinical instrument scores. Military personnel adherent to PAP had significantly improved sleepiness (p = 0.007), sleep quality (p = 0.013), depressive symptoms (p = 0.01), energy/fatigue (p = 0.027), and emotional well-being (p = 0.024). Participants with moderate-severe OSA were more likely to be in the adherent group when compared with participants diagnosed with mild OSA.

Conclusions: Military personnel with OSA have low adherence to PAP. Adherence is associated with improved depressive symptoms, sleepiness, sleep quality, energy/fatigue, emotional well-being, and social functioning. Future research should focus on interventions to improve the management of OSA in military personnel.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Continuous Positive Airway Pressure / psychology*
  • Depression / etiology*
  • Fatigue / etiology
  • Humans
  • Male
  • Middle Aged
  • Military Personnel / psychology*
  • Patient Compliance*
  • Sleep / physiology
  • Sleep Apnea, Obstructive / psychology*
  • Sleep Apnea, Obstructive / therapy
  • United States
  • Young Adult