Post-traumatic stress disorder with comorbid obstructive sleep apnea after the Great East Japan Earthquake: A case report.
5 affiliations
- 1Department of Psychiatry, Aizu Medical Center Fukushima Medical University Aizuwakamatsu Japan.
- 2Department of Neuropsychiatry Fukushima Medical University Fukushima Japan.
- 3Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan.
- 4Department of Community Cardiovascular Medicine Fukushima Medical University Fukushima Japan.
- 5Department of Clinical Laboratory Sciences Fukushima Medical University Fukushima Japan.
Abstract
Background
Post-traumatic stress disorder (PTSD) is frequently accompanied by sleep disturbance, and obstructive sleep apnea (OSA) is an important potential comorbidity. Although PTSD-OSA coexistence has been reported mainly in military veterans, reports after natural disasters remain limited. We describe a patient who developed PTSD after the Great East Japan Earthquake (GEJE) and was subsequently diagnosed with severe OSA.Case presentation
A 55-year-old man with hypertension and dyslipidemia, but no prior psychiatric illness, experienced temporary burial under rubble during the GEJE. He subsequently developed persistent trauma-related nightmares, depressed mood, and panic responses to disaster-related cues and was diagnosed with PTSD. Paroxetine and alprazolam improved mood and panic symptoms, whereas nightmares, excessive daytime sleepiness, and impaired concentration persisted. Polysomnography later demonstrated severe OSA (apnea-hypopnea index, 41.6 events/h; rapid eye movement (REM) AHI, 47.6 events/h; minimum oxygen saturation, 79%). Continuous positive airway pressure (CPAP) was initiated without changes to psychiatric treatment. Daytime sleepiness improved, and nightmare frequency decreased from almost daily to approximately weekly during the period of CPAP treatment, although adherence was low and symptoms later recurred after treatment interruption.Conclusion
This case illustrates that persistent nightmares, sleepiness, and impaired daytime functioning in a patient with PTSD may coexist with clinically significant OSA. Because longitudinal standardized PTSD measures were unavailable and CPAP adherence was limited, the observed improvement cannot be attributed to CPAP alone. Systematic assessment for sleep disorders, including OSA, should be considered when sleep-related or daytime symptoms persist during psychiatric treatment.
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BibTeX
@article{suzutani2026posttraumatic,
title = {{Post-traumatic stress disorder with comorbid obstructive sleep apnea after the Great East Japan Earthquake: A case report.}},
author = {Ken Suzutani and Tomofumi Misaka and Hiromu Ono and Tetsuya Shiga and Shuntaro Itagaki and Akiomi Yoshihisa and Shinobu Kawakatsu and Yasuchika Takeishi and Itaru Miura},
journal = {PCN reports : psychiatry and clinical neurosciences},
year = {2026},
month = oct,
doi = {10.1002/pcn5.70433},
url = {https://europepmc.org/article/MED/42923492},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Post-traumatic stress disorder with comorbid obstructive sleep apnea after the Great East Japan Earthquake: A case report.
AU - Ken Suzutani
AU - Tomofumi Misaka
AU - Hiromu Ono
AU - Tetsuya Shiga
AU - Shuntaro Itagaki
AU - Akiomi Yoshihisa
AU - Shinobu Kawakatsu
AU - Yasuchika Takeishi
AU - Itaru Miura
PY - 2026
DA - 2026/10/22
JO - PCN reports : psychiatry and clinical neurosciences
DO - 10.1002/pcn5.70433
UR - https://europepmc.org/article/MED/42923492
AB - Background Post-traumatic stress disorder (PTSD) is frequently accompanied by sleep disturbance, and obstructive sleep apnea (OSA) is an important potential comorbidity. Although PTSD-OSA coexistence has been reported mainly in military veterans, reports after natural disasters remain limited. We describe a patient who developed PTSD after the Great East Japan Earthquake (GEJE) and was subsequently diagnosed with severe OSA.Case presentation A 55-year-old man with hypertension and dyslipidemia, but no prior psychiatric illness, experienced temporary burial under rubble during the GEJE. He subsequently developed persistent trauma-related nightmares, depressed mood, and panic responses to disaster-related cues and was diagnosed with PTSD. Paroxetine and alprazolam improved mood and panic symptoms, whereas nightmares, excessive daytime sleepiness, and impaired concentration persisted. Polysomnography later demonstrated severe OSA (apnea-hypopnea index, 41.6 events/h; rapid eye movement (REM) AHI, 47.6 events/h; minimum oxygen saturation, 79%). Continuous positive airway pressure (CPAP) was initiated without changes to psychiatric treatment. Daytime sleepiness improved, and nightmare frequency decreased from almost daily to approximately weekly during the period of CPAP treatment, although adherence was low and symptoms later recurred after treatment interruption.Conclusion This case illustrates that persistent nightmares, sleepiness, and impaired daytime functioning in a patient with PTSD may coexist with clinically significant OSA. Because longitudinal standardized PTSD measures were unavailable and CPAP adherence was limited, the observed improvement cannot be attributed to CPAP alone. Systematic assessment for sleep disorders, including OSA, should be considered when sleep-related or daytime symptoms persist during psychiatric treatment.
SN - 2769-2558
ER -