A recent article in CHEST which is the monthly publication for the American College of Chest Physicians caught my eye because of its interesting title, “Sleeping With the Enemy”.
Obstructive sleep apnea (OSA) is an important condition because of its high prevalence, its symptom burden, its association and ability to exacerbate other diseases and its association with an increased risk of death.
OSA in military personnel differs from the civilian population in several ways. The environment in which the military work is a high-performance, operationally critical circumstance. This raises the broader concern about OSA in the military. Osa in the military differs in a number of ways from that of the civilian population. The military population is often younger, leaner and more physically active and have fewer co-morbidities. The presence of attention deficits and decreases in vigilance are much more common in military personnel. These issues are potentially important drivers of the increased risk of traumatic brain injury and musculoskeletal injuries.
Daytime sleepiness, characteristic of OSA, impairs vigilance, reaction time and situational awareness which can increase the likelihood of workplace accidents and battlefield injuries. Even mild OSA may cause problems with military readiness. Newly diagnosed OSA has been associated with an almost 4-fold risk for PTSD within 12 months of diagnosis.
OSA in the military has unique implications for diagnosis and care. The need for care in the military may not follow the same guidelines as the civilian population. More attention needs to be paid to this specialized group.
