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Signs and Symptoms of Sleep-Disordered Breathing in Trauma Survivors: A Matched Comparison With Classic Sleep Apnea Patients

Krakow, Barry MD*†‡§; Melendrez, Dominic BS, RPSG-T*; Warner, Teddy D. PhD†‡; Clark, Jimmy O. BS*; Sisley, Brandy N. BA, RPSG-T*; Dorin, Richard MD∥#; Harper, Ronald M. PhD¶; Leahigh, Lisa K.*; Lee, Samuel A. BA*; Sklar, David MD†§; Hollifield, Michael MD†‡**

Journal of Nervous & Mental Disease: June 2006 - Volume 194 - Issue 6 - pp 433-439
doi: 10.1097/01.nmd.0000221286.65021.e0
Original Articles

Chronic posttraumatic sleep disturbance may include sleep-disordered breathing (SDB), but this disorder of sleep respiration is usually not suspected in trauma survivors. Sleep breathing signs and symptoms were studied in 178 adults—all with SDB—including typical sleep clinic patients (N = 89) reporting classic snoring and sleepiness and crime victims (N = 89) with insomnia and posttraumatic stress. Significant differences (p < 0.0001) were common between groups. Sleep breathing complaints, loud snoring, marked obesity, and obstructive sleep apnea were prevalent in sleep clinic patients; crime victims reported more insomnia, nightmares, poor sleep quality, leg jerks, cognitive-affective symptoms, psychotropic medication usage, and less snoring but more upper airway resistance syndrome. Both groups reported high rates of fatigue or sleepiness, nocturia, morning dry mouth, and morning headaches. Awareness of these clinical features might enhance detection of SDB among trauma survivors.

*Sleep and Human Health Institute, Albuquerque, New Mexico; †University of New Mexico Health Sciences Center, Albuquerque, New Mexico; ‡Department of Psychiatry, University of New Mexico Health Sciences Center, Albuquerque, New Mexico; §Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico; ∥New Mexico Veterans Administration Healthcare System, Albuquerque, New Mexico; #Departments of Medicine and Biochemistry/Molecular Biology, University of New Mexico School of Medicine, Albuquerque, New Mexico; ¶Department of Neurobiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California; and **Department of Family Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.

Supported by grants from the New Mexico Crime Victims Reparation Commission, Frost Foundation, and Oxnard Foundation.

Dr. Krakow owns and operates two commercial Web sites that sell products and services for the treatment of sleep disorders.

Send reprint requests to Barry Krakow, MD, Sleep and Human Health Institute, 6739 Academy NE, Suite 380, Albuquerque, NM 87109.

© 2006 Lippincott Williams & Wilkins, Inc.