Sleep Apnea-Hypopnea Syndrome in a Sample of Veterans of the Persian Gulf War

Abstract

The prevalence of sleep apnea-hypopnea syndrome (SAHS) was investigated in a selected group of veterans of the Persian Gulf War at Brooke Army Medical Center. One hundred ninety-two self-referred patients participated in the full evaluation of the Comprehensive Clinical Evaluation Program (CCEP) for veterans of the Persian Gulf War. After completing an initial survey, an interview and examination were performed by staff internists. Forty-six participants with histories suggestive of a sleep disorder were referred for further evaluation. Those patients suspected of SAHS then completed a sleep disorders questionnaire and underwent standard nocturnal polysomnography (PSG). SAHS was defined as a respiratory disturbance index > or = 15 in a symptomatic patient. Fifteen of 46 patients undergoing PSG at this institution met criteria for SAHS. The majority of these patients had symptoms of fatigue and memory loss. Overall, 16 of the 192 patients (8.3%) in the CCEP of our institution were diagnosed with SAHS. SAHS may play a significant role in the symptom complex presented by many veterans of the Persian Gulf War.

Proteomic CNS Profile of Delayed Cognitive Impairment in Mice Exposed to Gulf War Agents

“…Hence, our data support a psychomotor-related dysfunction rather than fine motor coordination problems, observations that are similar to that reported for another organophosphate AChE inhibitor pesticide, diisopropylfluorophosphate (Terry et al 2011). It is also possible that these GW-agent-induced neurobehavioral changes may be a consequence of circadian abnormalities, often reported by veterans with GWI (Haley et al 2004;Peacock et al 1997), and as such, likely to be a consequence of GW agent exposure. Nevertheless, the observed delayed presentation of neurobehavioral symptoms in GW agent-exposed mice is consistent with the observation of delayed manifestation of GWI in veterans, where 60% of GWI symptoms developed once veterans returned from the war, and 40% of the symptoms emerged years later (Kroenke et al 1998).…”

Obstructive sleep apnea and ischemic heart disease in southwestern US veterans: implications for clinical practice

“…Prevalence rates for OSA are consistent with a younger sample of Gulf War 1 veterans [29]. Higher BMI, in combination with higher rates of diabetes and sleep symptoms, are consistent with comorbid sleep conditions that suggest poorer health outcome and quality of life noted in studies of civilians with OSA [1,2,4,9,32,33].…”

“…Nevertheless, associations between OSA and CVD in this relatively small sample are consistent with large national studies [15][16][17][18]. Furthermore, we acknowledge that we cannot rule out preferential participation of subjects with ischemia given that this study was advertised as "diet and stroke risk"; however, it is unlikely that participants self-selected based on OSA because the study was not advertised as such, and prevalence rates of OSA in this study are similar to other military veterans [29]. Minority groups other than Mexican-Americans were not recruited for this study, in part, because of the Vascular Center focus on Mexican-American-Hispanics, the largest minority group in the southwest desert.…”

“…Although there have been several studies documenting the prevalence of OSA in general populations of civilians, there has been little information to date on prevalence rates for OSA in military veterans, a group with a high rate of chronic medical problems. Interestingly, we found that the rate for self-reported physician-diagnosed OSA in these middle to older age veterans (8.1%) parallels the rate for self-referred early-to middle-aged Persian Gulf War 1 veterans in the Brooke Army Medical Center Comprehensive Clinical Evaluation Program, who underwent overnight polysomnography (8.3% of 192) [29]. Thus, the prevalence of OSA in middle to older age veterans appears to be higher than comparable civilian populations.…”

Insomnia Severity, Subjective Sleep Quality, and Risk for Obstructive Sleep Apnea in Veterans With Gulf War Illness

“…Peacock et al 6 reported sleep apnea-hypopnea syndrome in 8% of the participants of a Comprehensive Clinical Evaluation Program for GW veterans at Brooke Army Medical Center in Texas. Although 8% is slightly higher than the estimated prevalence of OSA in the general adult male population (3–7%), 7 another study failed to find evidence of increased sleep apnea in 22 ill GW veterans compared to 19 matched control GW veterans.…”