Significant Health and Resource Challenges of Sleep Apnea in U.S. Military Personnel

Recent research from the University of Maryland School of Medicine has revealed concerning health and resource implications of sleep apnea among active-duty military personnel in the United States. The study highlights that over 10% of Americans suffer from obstructive sleep apnea, a condition that significantly increases the likelihood of developing severe health issues, including heart disease.

The findings indicate that soldiers diagnosed with sleep apnea are more than four times more likely to experience post-traumatic stress disorder (PTSD) and three times more likely to sustain a traumatic brain injury compared to their peers without the disorder. Published in the journal CHEST, this comprehensive study represents the most extensive examination of the health impacts and resource burdens posed by sleep apnea within the military.

Lead author Emerson M. Wickwire, who is also the Section Chief of Sleep Medicine at the University of Maryland School of Medicine, emphasized the critical need for early detection and intervention for sleep apnea among service members. He stated that quantifying the health and resource burden of this condition could assist in directing clinical resources within the military health system, including enhancing provider education and improving patient screening and treatment.

Obstructive sleep apnea is characterized by repeated interruptions in breathing during sleep, leading to a range of health risks, such as type 2 diabetes, heart attacks, strokes, and depression. Symptoms typically include chronic snoring, excessive daytime sleepiness, and alterations in mood and behavior.

Military personnel often face demanding work schedules that hinder their ability to achieve the recommended seven hours of sleep each night. Research indicates that only one-third of active-duty service members manage to meet this sleep guideline. Furthermore, there has been a significant increase in sleep apnea diagnoses within the military, with reported cases skyrocketing from 11 to 333 per 10,000 service members between 2005 and 2019.

In conducting the study, researchers utilized anonymized data from the Military Health System repository, creating two matched cohorts of nearly 60,000 active-duty service members aged 17 to 64, one group diagnosed with obstructive sleep apnea and the other without. The study revealed that, within the year following a sleep apnea diagnosis, affected service members incurred an additional 170,511 outpatient medical visits, 1,852 emergency department visits, and 66 hospitalizations compared to their counterparts.

Moreover, those with sleep apnea exhibited a higher risk and quicker onset of various medical issues, including PTSD, anxiety, depression, traumatic brain injuries, and musculoskeletal injuries. Col. Vincent F. Capaldi, II, Chair of Psychiatry at the Uniformed Services University, pointed out that sleep apnea extends beyond being a mere medical concern; it poses a significant threat to military readiness.

The collaboration between the University of Maryland School of Medicine and the Uniformed Services University aims to address the shortage of sleep specialists within the military health system. They are initiating a new clinical trial called 'Tele-Sleep OSA,' which seeks to evaluate the effectiveness and cost-efficiency of telehealth consultations for military personnel diagnosed with sleep apnea.

Mark T. Gladwin, Dean of the University of Maryland School of Medicine, expressed eagerness to commence patient enrollment in this vital study, which aims to enhance health outcomes for military members. With fewer than 40 active-duty sleep physicians available in the military health system, improving access to specialists is critical. Research has shown that providing continuous positive airway pressure (CPAP) treatment can significantly lower the risk of mortality related to heart conditions by 55% and overall mortality by 37%.