title: Adherence to positive airway pressure therapy in U.S. military personnel with sleep apnea improves sleepiness, sleep quality, and depressive symptoms.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pulmonary, Sleep Medicine, Critical Care, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA 98431.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mysliwiec
authors.affiliation: Walter Reed Army Institute of Research, 508 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Vincent F
authors.initials: VF
authors.lastname: Capaldi
authors.affiliation: National Institutes of Health, 10 Center Drive, Bethesda, MD 20892.
authors.forename: Jessica
authors.initials: J
authors.lastname: Gill
authors.affiliation: Department of Pulmonary, Sleep Medicine, Critical Care, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA 98431.
authors.forename: Tristin
authors.initials: T
authors.lastname: Baxter
authors.affiliation: Department of Pulmonary, Sleep Medicine, Critical Care, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA 98431.
authors.forename: Brian M
authors.initials: BM
authors.lastname: O'Reilly
authors.affiliation: Department of Operations Research, Naval Postgraduate School, 1411 Cunningham Road, Monterey, CA 93943.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Matsangas
authors.affiliation: Department of Pulmonary, Sleep Medicine, Critical Care, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA 98431.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Roth
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D003863:Depression / Q000209:etiology*; D005221:Fatigue / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D010349:Patient Compliance; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy; D014481:United States; D055815:Young Adult