Anxiety Clinical Trial
Official title:
The Effect of Nasal Continuous Positive Airway Pressure (Nasal CPAP) Treatment on Post Traumatic Stress Disorder (PTSD) Symptoms.
We hypothesize that prevention of Sleep Disordered Breathing among PTSD patients with nasal CPAP will result improve their anxiety, insomnia and alcohol craving (among those who use alcohol to control their symptoms).
Design: This is a pilot study to study the effect of nasal CPAP on the symptoms of PTSD in
veterans.
Recruitment Methods:
Veterans with PTSD will be recruited from the Northport VAMC PTSD unit. The ACOS/Mental
Health will refer patients that meet inclusion criteria and do not have an impaired decision
making capacity. Subjects will be screened for decision-making capacity by their treating
psychiatrist as part of their clinical assessment upon admission to the PTSD unit.
Study Methods
This will be a prospective, randomized, controlled interventional trial:
1. Participants will undergo a routine clinical sleep study at the PTSD unit (using a
portable polysomnographic recording unit). or undergo a routine clinical
polysomnography to diagnose sleep disordered breathing
2. Participants who demonstrate SDB will be randomized into two groups based upon their
body mass index
1. Group A: BMI < 30 kg/m2
2. Group B: BMI > 30 kg/m2 The reason for these two arms is to study the effect of
nasal CPAP upon PTSD symptoms in veterans with a high prevalence of sleep apnea (
BMI above 30 kg/m2) and in veterans with predominantly snoring (BMI below 30
kg/m2).
Each group will then be randomized into two sub-groups regarding treatment.
1. Treatment group receives an automated CPAP unit to use during sleep for 6 weeks in
conjunction with their usual care in the PTSD unit (psychotherapy).
2. Control group receives the usual care that is provided in the PTSD unit for 6
weeks (change in medications will exclude the subject from the study), if any
participant in the control group would like to try nasal CPAP, then he will be
crossed over to use an automated CPAP unit during sleep for his second 6 weeks in
the PTSD unit together with usual care.
3. All participants will fill out the following questionnaires at baseline and after 6
weeks. (Those in the control group who have been crossed-over to nasal CPAP will also
fill out a set of questionnaire at 12 weeks).
1. PTSD checklist-military version (anxiety)
2. MASQ anxious arousal subscale (anxiety)
3. Insomnia Severity Index (insomnia)
4. The alcohol craving questionnaire (with an alcohol history during the intake) The
changes in patient's reported outcomes will be compared before and after CPAP
treatment and psychotherapy alone
;
Observational Model: Case-Crossover, Time Perspective: Prospective
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