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This study investigates the prevalence of obstructive sleep apnea (OSA) and the ventilatory response to arousal in young adults with PTSD symptoms post non-military trauma.

May 9, 2026Open Access

The ventilatory response to arousal from sleep is elevated in young individuals with post-traumatic stress disorder symptoms

Key Points

This study investigates the prevalence of obstructive sleep apnea (OSA) and the ventilatory response to arousal in young adults with PTSD symptoms post non-military trauma.
Individuals with PTSD symptoms completed overnight sleep studies to assess OSA prevalence and ventilatory responses.
Participants categorized as Likely PTSD, Subsyndromal PTSD, or No PTSD based on PCL-5 scores.
Compared ventilatory responses and OSA prevalence among the groups.
OSA prevalence was found to be 4 in Likely PTSD, 3 in Subsyndromal PTSD, and 1 in No PTSD group (p=0.21).
The mean apnea-hypopnea index was similar across groups (p<0.98).
Ventilatory response to arousal was significantly greater in Likely PTSD and Subsyndromal PTSD compared to No PTSD (p<0.001).

Abstract

Obstructive sleep apnea (OSA) is reported to be more prevalent in posttraumatic stress disorder (PTSD) compared to the general population for unknown reasons. Most prior studies have assessed military populations who commonly possess other OSA risk factors. This study aimed to determine whether: 1) OSA prevalence is increased in young adults with PTSD symptoms exposed to non-military traumas; and 2) the ventilatory response to arousal from sleep - an OSA pathogenic trait - differs according to PTSD symptoms. Individuals with a range of PTSD symptoms (PTSD symptom checklist for DSM-5, PCL-5) completed an overnight sleep study. OSA prevalence and the ventilatory response to brief spontaneous arousals were compared between those with Likely PTSD (trauma exposure, intrusions and PCL-5 > 33), Subsyndromal PTSD (trauma exposure, intrusions and PCL-5 15-33) and No PTSD (PCL-5 < 15). Data were obtained in 60 individuals, 18 with Likely PTSD, 19 Subsyndromal PTSD and 23 No PTSD. The number found to have OSA (4 in Likely PTSD, 3 in Subsyndromal PTSD and 1 in No PTSD, p = .21) and the mean apnea-hypopnea index did not differ between groups (p < .98). The ventilatory response to arousal was assessed in 29 individuals without OSA who had good nasal pressure traces and was significantly larger in individuals with Likely PTSD and subsyndromal PTSD than No PTSD (p < .001). Although these young individuals with Likely PTSD did not commonly have OSA, the ventilatory response to arousal was elevated, which when combined with other OSA risk factors may predispose to OSA. Obstructive sleep apnea has been reported to be much more common in military veterans with posttraumatic stress disorder (PTSD) than in the general population. Whether this is a result of factors specific to military veterans or due to other reasons was unknown. This study found that young adults with non-military trauma exposure and likely PTSD did not have elevated rates of OSA. However, their ventilatory response to brief spontaneous arousal from sleep was elevated, which may contribute to OSA development when other risk factors are present (older age, obesity etc) and may also represent a PTSD-specific OSA treatment pathway.

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