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Veterans with post-traumatic stress disorder (PTSD) who received esketamine treatment experienced less improvement in their symptoms if they had high end sleep apnea (OSA) severity at the beginning of the study.
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The study presented at the American Thoracic Society International Conference highlights the potential interference of untreated OSA with the effectiveness of esketamine treatment for PTSD symptoms.
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The researchers examined 24 veterans with PTSD symptoms who were undergoing esketamine treatment and assessed the impact of OSA severity, measured by apnea-hypopnea index (AHI) scores, on treatment outcomes.
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To be included in the study, participants had to fulfill three criteria: completion of a home sleep test, administration of the PTSD Checklist for DSM-5 (PCL-5), and previous unsuccessful trials of at least two different medications for depression or PTSD within the last two years.
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During the initial four weeks of treatment, veterans received esketamine twice a week, followed by a once-a-week dose thereafter.
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Changes in PTSD symptoms were measured using PCL-5 scores obtained at each esketamine administration, allowing researchers to track improvements or declines over the treatment period.
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After adjusting for age, the researchers analyzed how the number of esketamine doses and baseline AHI scores influenced the PCL-5 scores.
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Higher baseline obstructive sleep apnea (OSA) severity was associated with less improvement in PTSD symptoms as the number of esketamine doses increased, despite overall decreases in PCL-5 scores indicating symptom improvement.