Summary: A large matched-cohort study found that active-duty service members newly diagnosed with OSA faced significantly higher risks of PTSD, traumatic brain injury, depression, and greater healthcare utilization—prompting efforts to expand telehealth sleep care amid a critical shortage of military sleep physicians.
Key takeaways:
- Active-duty U.S. service members with OSA were over four times more likely to develop PTSD and three times more likely to sustain a traumatic brain injury within a year of diagnosis.
- The study, using data from nearly 120,000 matched service members, also found increased risks of anxiety (3.4x), depression (3.0x), and musculoskeletal injuries (1.7x).
- OSA was linked to an additional 170,511 outpatient visits, 1,852 emergency visits, and 66 hospitalizations annually compared to matched peers.
- Researchers and military physicians warn these findings reveal OSA is not just a health concern but a threat to force readiness, underscoring the need for early detection and treatment.
US active-duty military members with obstructive sleep apnea (OSA) who are serving on the front lines are more than four times more likely to experience post-traumatic stress disorder and three times more likely to suffer a traumatic brain injury compared to those who don’t have the condition, according to a new study done by University of Maryland School of Medicine (UMSOM) investigators.
OSA: Hidden Threat to Operational Readiness?
Conducted in conjunction with Uniformed Services University, “this study underscores the growing importance of early intervention in sleep apnea and access to high quality, cost-effective sleep care for service members,” says Emerson M. Wickwire, PhD, lead study author and Section Chief of Sleep Medicine at the University of Maryland School of Medicine, in a release. “By quantifying the health and resource burden of this condition we hope to help guide the development and allocation of clinical resources within the military health system, including advancing provider education and patient screening, triage, and treatment.”
Large Matched-Cohort Study Highlights Medical Impact
Wickwire and his colleagues utilized de-identified data from the Military Health System data repository to create two matched cohorts of individuals with and without OSA, comprised of nearly 60,000 service members each, ages 17-64 years. Service members with newly diagnosed OSA were matched with those without controlling for demographic, clinical, and military characteristics. The researchers found that during the 12 months following diagnosis, service members with OSA had an additional 170,511 outpatient visits to doctors compared to their counterparts and an additional 1,852 emergency department visits per year and 66 hospitalizations.
Mental Health and Injury Risks
They also had a higher risk and faster time to specific medical problems including:
- PTSD: 4.4x increased risk
- Anxiety: 3.4x increased risk
- Traumatic Brain Injury: 3.3x increased risk
- Depression: 3.0x increased risk
- Musculoskeletal Injuries: 1.7x increased risk
Call to Action
“This study is a wake-up call. Sleep apnea is not just a medical condition—it’s a force readiness issue. The findings highlight how untreated sleep disorders contribute to mental health challenges, traumatic injuries, and increased health care utilization in our service members. Our collaboration with UMSOM underscores the urgent need to enhance access to timely, effective, and evidence-based sleep care throughout the Military Health System. We must prioritize sleep health as a cornerstone of operational performance and long-term wellbeing for the force,” says Col. Vincent F. Capaldi, II, ScM, MD, Chair of Psychiatry at the Uniformed Services University, in a release.
With the hopes to address the documented shortage of sleep specialists in the military health system, UMSOM and USU are working together to launch a new clinical trial called “Tele-Sleep OSA” to evaluate the clinical and cost-effectiveness of tele-health visits for military beneficiaries who are diagnosed with the condition.
“We are eager to begin enrolling patients in this important study to help improve overall health outcomes in our U.S. military population,” says Mark T. Gladwin, MD, Dean of the University of Maryland School of Medicine, Vice President for Medical Affairs, University of Maryland, Baltimore (UMB), and the John Z. and Akiko K. Bowers Distinguished Professor. “With fewer than 40 active-duty sleep physicians in the military health system, there is a clear need for better access to sleep physicians for our military personnel, and studies show providing CPAP treatment to those in need can reduce their risk of dying from heart-related causes by 55% and from any cause by 37%.”
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