RECRUITINGINTERVENTIONAL

OSA PAP Treatment for Veterans With SUD and PTSD on Residential Treatment Unit

Examining Early Intervention Obstructive Sleep Apnea Treatment on Long-Term Outcomes in Veterans With SUD/PTSD in a Residential Treatment Program

About This Trial

Substance use disorder (SUD) and posttraumatic stress disorder (PTSD) frequently co-occur and having both disorders is associated with greater psychological and functional impairment than having either disorder alone. This is especially true in residential settings where both disorders are more severe than outpatient settings. Obstructive sleep apnea (OSA) is highly comorbid with both disorders and untreated OSA is associated with worse functional impairment across multiple domains, worse quality of life, worse PTSD, higher suicidal ideation, and higher substance use and relapse rates. Treating OSA with evidence-based positive airway pressure (PAP) in Veterans with SUD/PTSD on a residential unit is a logical way to maximize treatment adherence and treatment outcomes. This study compares OSA treatment while on a SUD/PTSD residential unit to a waitlist control group. The investigators hypothesize that treating OSA on the residential unit, compared to the waitlist control, will have better functional, SUD, and PTSD outcomes.

Who May Be Eligible (Plain English)

Who May Qualify: - a Veteran of the U.S. military or Reserve/National Guard member - at least 18 years of age - have an AHI 5 per hour - experienced trauma that occurred in childhood or adulthood; at least one month post-trauma - have current DSM-5 diagnoses of SUD via SCID-SUD module with a minimum 20 days of substance use in the last 90 days (Timeline Follow-back) - Full PTSD diagnosis via clinician administered PTSD scale - are literate in English - are on the PTSD track of the SARRTP unit - are capable of giving willing to sign a consent form Who Should NOT Join This Trial: - have central sleep apnea (AHI \>=5 and \> 50% central apneas) - arrives on the SARRTP unit already using a PAP device (Veteran's previously diagnosed with OSA, but not using PAP therapy will be eligible) - the SARRTP medical staff advises against the study based on medical history and physical examination; d) history of severe cognitive impairment (via MOCA \< 26) - history of psychosis or mania independent of substance use will be excluded because the presence of these disorders can impede therapy progress Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language

Inclusion Criteria: * a Veteran of the U.S. military or Reserve/National Guard member * at least 18 years of age * have an AHI 5 per hour * experienced trauma that occurred in childhood or adulthood; at least one month post-trauma * have current DSM-5 diagnoses of SUD via SCID-SUD module with a minimum 20 days of substance use in the last 90 days (Timeline Follow-back) * Full PTSD diagnosis via clinician administered PTSD scale * are literate in English * are on the PTSD track of the SARRTP unit * are capable of giving informed consent Exclusion Criteria: * have central sleep apnea (AHI \>=5 and \> 50% central apneas) * arrives on the SARRTP unit already using a PAP device (Veteran's previously diagnosed with OSA, but not using PAP therapy will be eligible) * the SARRTP medical staff advises against the study based on medical history and physical examination; d) history of severe cognitive impairment (via MOCA \< 26) * history of psychosis or mania independent of substance use will be excluded because the presence of these disorders can impede therapy progress

Treatments Being Tested

DEVICE

Positive Airway Pressure Device

Each PAP treatment initiation meeting will include 1) mask fitting; 2) psycho-education to what to expect and reviewing PAP machine problem solving; and 3) setting up correct PAP treatment (e.g., auto PAP or in rare conditions, bi-level PAP).

Locations (1)

VA San Diego Healthcare System, San Diego, CA

San Diego, California, United States