Relationship between posttraumatic stress disorder and self-reported physical symptoms in Persian Gulf War veterans.

BACKGROUND: While prior studies show that combat veterans with posttraumatic stress disorder (PTSD) report more physical symptoms than veterans without PTSD, the link between PTSD and somatic complaints in Persian Gulf War veterans (PGWVs) is yet to be evaluated. METHODS: A questionnaire booklet was completed by 188 PGWVs, of whom half were patients in a veterans health screening clinic and half were non-treatment-seeking volunteers on active duty. The booklet included the Combat Exposure Scale, the Mississippi Post-Traumatic Stress Disorder Scale (MPTSD), and a subjective symptom-based health questionnaire. RESULTS: The 24 PGWVs (12.8%) with PTSD (MPTSD score > or = 116) reported more combat exposure (P = .02) and a greater number of physical symptoms (P = .001) than other PGWVs. Fatigue, nausea, muscle aches, dizziness, back pain, stomach ache, and numbness were much more likely to be reported by those with PTSD (MPTSD score > or = 116) than by those without PTSD (MPTSD score < or = 95). CONCLUSIONS: Physicians examining PGWVs should be alert to the possibility of PTSD in this group and that those with PTSD are more likely to report physical symptoms that may overlap with those in Persian Gulf syndrome. Consequently, mental health screening is essential, since for those veterans with PTSD diagnosis of other coexisting conditions may be confounded and early effective treatment of their PTSD may be delayed. Also, given the increased reporting of certain symptoms by those with PTSD, those seeking the cause of Persian Gulf syndrome should control for PTSD when determining the symptom cluster that may constitute this condition.

Sleep-disordered breathing in the healthy elderly. Clinically significant?

We evaluated sleep/wake, medical, and psychological parameters in a cohort of healthy men and women between 50 and 80 years of age. Consistent with previous investigations of sleep-disordered breathing (SDB) in older persons, nocturnal breathing disturbances were quite common in our normal-aged subjects, with more than 15 percent experiencing five or more SDB events per hour of sleep. However, when SDB indices were correlated with comprehensive measures of daytime functioning, the number of statistically significant relationships was at or below expectations from chance alone. Additionally, comparison of high-SDB subjects (AHI greater than or equal to 5) with low-SDB subjects (AHI less than 5) failed to reveal reliable differences on measures of daytime functioning. We conclude that SDB occurring in otherwise healthy older persons is not a cause for immediate concern, although longitudinal studies may yet demonstrate significant long-term sequelae of SDB in this population.

Sleep-disordered breathing in healthy aged persons: one-year follow-up of daytime sequelae.

We studied the waking medical, sleep, and psychological status of 28 healthy older persons who had undergone nocturnal polysomnography and daytime assessment approximately 1-year earlier. In a previous report based on this sample, we found that sleep-disordered breathing (SDB) indices were not related to concurrent measurements of daytime functioning. However, in the present study, we observed relationships between the original SDB indices and several measures of cardiopulmonary functioning obtained 1 year later. At follow-up, subjects with originally high levels of SDB had significantly higher systolic blood pressure and poorer pulmonary function test results, were more likely to report irregular heartbeats in the previous year, and had experienced more disruptive snoring than the remaining subjects. When combined with other recent data, these results raise the possibility that SDB exerts an insidious pathological influence on the health and daytime functioning of otherwise healthy older persons.