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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Dear Dr.! I am a veteran of Operation Iraqi Freedom

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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3543 Questions

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Posted on Tue, 15 Jan 2019 in Brain and Spine
Question: Dear Dr.! I am a veteran of Operation Iraqi Freedom , served in 2005, I am rated at 50% disabled due tu PTSD, in the last 3 months I got a sleep study that shows sleep apnea / partly obstruvtive but more central, I have been placed on a cpap machine by my VA Dr. My question is do your believe my sleep apnea was brought on by my PTSD? Or does my PTSD aggravate my Sleep apnea , i have had problems leaving the mask on all night because i wake up with panic attacks and cant breath and feel like i need to take the cpap mask off. Also my sleep study showed alpha brain waves in XXXXXXX ,...
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Answered by Dr. Olsi Taka 1 hour later
Brief Answer:
PTSD increases risk of sleep apnea.

Detailed Answer:
Hello and welcome to HealthcareMagic! I read your question carefully and I understand your concern.

You are raising a hypothesis which is not without ground. It has been observed by several studies that there is a higher frequency of sleep apnea in patients suffering from PTSD. Many studies include small numbers of patients (and the syndromes may be confused as they do have overlapping symptoms) so there is still debate on precise figures and relevance of individual studies. However almost all indicate that there is a link between the two conditions.
Saying that it was brought on solely by PTSD would not be correct though, in most patients sleep apnea is not related to PTSD, may have other origin. PTSD would be an additional factor increasing the likelihood of developing sleep apnea even more in predisposed patients and aggravating it though. Furthermore it makes it more difficult to treat sleep apnea as PTSD patients find it more difficult to adhere to the mask as you yourself have noted.

As for the issue of alpha brain waves in XXXXXXX I assume the appearance of alpha waves during deep sleep stage, when there shouldn't be any alpha activity. That is a phenomenon which is not well understood and studied, however it is thought to result in a lower sleep quality and further contribute to the chronic fatigue resulting from sleep apnea. It is thought to be linked to fibromyalgia, a disorder characterized by widespread muscle and skeletal pain, mood and sleep disorders (as you can see may have common mechanisms your conditions).

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka 1 hour later
Dear Dr.,

Thank you for your previous answers,

Also I have polycythemia ( red blood cell count)

I have been having the following symptoms
Bleeding gums
Dull headache
Joint pain
Fatigue
Randoms shooting pain in joints
Noticed heart arrhythmia( alarming)
Hearing voices when awakaing and sleeping
Loud noises also on awaking and sleeping

Are all these symptoms from polycythemia??? What do you think might have caused my polycythemia?
doctor
Answered by Dr. Olsi Taka 16 minutes later
Brief Answer:
Yes may be due to polycythemia.

Detailed Answer:
Thank you for the follow up!

In many patients polycythemia doesn't cause any symptoms. In some cases (depending on the values on blood tests) it may cause many of those symptoms such as the headaches, bleeding gums, fatigue, joint pain and shooting sensations, heart arrhythmia (the last two symptoms you mention are less common, might be more likely related to PTSD and sleep disorder). So if hematocrit levels are very elevated the symptoms may well be due to polycythemia.

As for what might have caused it....the possible causes can be many, so some tests are needed to search for possible causes.
It may be primary, meaning due to an abnormal production originating in the bone marrow, a sort of tumoral condition, but which rarely threats to progress to more malignant forms like leukemia, usually well controlled through blood removal procedures, aspirin and when necessary drugs to reduce red blood cell production.
There are also secondary forms of polycythemia, due to the bone marrow overproducing to cope with certain environments or conditions, such as living in high altitudes, suffering from lung or heart disease, using anabolic steroids, some rare cancers, some rare genetic conditions associated with difficulty releasing oxygen from hemoglobin etc. Among such secondary forms sleep apnea may also play a role in increasing hematocrit, although usually it is a mild increase, rarely enough to produce symptoms.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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