STARR Lab Current Research

The purpose of this study is to examine the mechanistic relationship between PTSD and OSA. We
are proposing to examine sleep architecture via Polysomnography and physiological startle
response via Startle Paradigm in Veterans with PTSD. We are interested in the effects of PTSD
treatment on sleep architecture.

Aim 1: Test the hypothesis that daytime hyperarousal contributes to low sleep arousal threshold (ArTH) and OSA pathogenesis in PTSD/OSA patients.

To examine the relationship between objective daytime PTSD arousal and sleep ArTH, approximately 60 individuals with PTSD (via PTSD Checklist) will undergo polysomnography (PSG; apnea-hypopnea index, ArTH, and loop gain) and a physiological arousal paradigm (startle-threshold task). We hypothesize that 1a) at least three OSA groups will emerge: no OSA (Mild collapsibility, normal/high ArTH), classic OSA (Severe collapsibility, ArTh not important), and low ArTH OSA (Mild collapsibility, Low ArTH); and 1b) among individuals with PTSD, the low ArTH OSA group will have a lower startle threshold (i.e., exhibit large startle response to sub-threshold stimuli) compared to those with normal/high ArTH.

Aim 2: Collect Data on endotyping to create a valid screening measure.

Given the atypical presentation of OSA among veterans with PTSD, current screening measures (e.g., Berlin and STOP-BANG) are not valid screening measures. To start the process of creatingvalid PTSD/OSA screeners, we will collect common mental and physical health questionnaires.

Aim 3: Collect sleep architecture data on pre- and post-PTSD treatment inform change in sleep
as a function of evidence based treatments.

To carry out these Aims, we have created a unique partnership of investigators with expertise in PTSD, physiological arousal, sleep, and OSA pathophysiology. The results of this mechanistic clinical trial would have immediate relevance to understanding the relationship between PTSD and OSA, and would help inform future studies of targeted interventions for PTSD/OSA
treatment.

 Electrical Vestibular Nerve Stimulation (VeNS) as a Treatment for PTSD