An analysis of fear inhibition and fear extinction in a sample of veterans with obstructive sleep apnea (OSA): Implications for co-morbidity with post-traumatic stress disorder (PTSD)

•Continuous positive airway pressure (CPAP) improved inhibition and extinction in Veterans with obstructive sleep apnea (OSA).•Severity of OSA was positively correlated with the degree of improvement in inhibitory and extinction learning.•Inhibitory and extinction learning was impaired in Veterans w...

Full description

Saved in:

Bibliographic Details
Published in:	Behavioural brain research Vol. 404; p. 113172
Main Authors:	Reist, Christopher, Jovanovic, Tanja, Kantarovich, Diana, Weingast, Leah, Hollifield, Michael, Novin, Mahmood, Khalaghizadeh, Sakineh, Jafari, Behrouz, George, Renie, Riser, Manessa, Woodford, Jessica, Norrholm, Seth D.
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 23-04-2021
Subjects:	Acoustic startle Adult Comorbidity Continuous Positive Airway Pressure Extinction, Psychological Fear - psychology Fear conditioning Fear extinction Female Humans Inhibitory learning Male Middle Aged Patient Acuity Posttraumatic stress disorder Sleep apnea Sleep Apnea, Obstructive - psychology Sleep Apnea, Obstructive - therapy Stress Disorders, Post-Traumatic - etiology Stress Disorders, Post-Traumatic - psychology Veterans - psychology Veterans - statistics & numerical data Young Adult Inhibitory learning Fear extinction Sleep apnea Posttraumatic stress disorder Acoustic startle Fear conditioning
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	•Continuous positive airway pressure (CPAP) improved inhibition and extinction in Veterans with obstructive sleep apnea (OSA).•Severity of OSA was positively correlated with the degree of improvement in inhibitory and extinction learning.•Inhibitory and extinction learning was impaired in Veterans with co-morbid OSA and posttraumatic stress disorder (PTSD). Obstructive sleep apnea (OSA) is a respiratory condition characterized by interrupted sleep due to repeated, temporary collapse of the soft tissue of the upper airway that can lead to a cascade of physiological and psychological adverse health outcomes. The most common therapeutic interventions for OSA patients include the application of continuous positive airway pressure (CPAP) which acts to keep the airway open and, as such, provides less interrupted and more restorative sleep. Improved sleep has been linked to more efficacious treatments for psychiatric conditions most notably those that include cognitive-behavioral elements, new learning, and memory consolidation. In the current study, we investigated the acquisition, inhibition, and extinction of conditioned fear in OSA patients, before and after CPAP therapy, using an established fear-potentiated startle paradigm. Patients with OSA displayed an intact ability to acquire, inhibit, and extinguish fear prior to CPAP treatment and this ability was significantly enhanced following CPAP usage. In addition, those patients with more severe OSA, as measured by apnea-hypopnea index (AHI), were more likely to show improved fear inhibition and extinction. Lastly, we observed impairments in discrimination between reinforced and nonreinforced conditioned stimuli, in the inhibition of fear, and in fear extinction in a subset of patients with OSA and co-morbid posttraumatic stress disorder (PTSD). These data suggest that evolving treatment algorithms for PTSD should address disrupted sleep problems prior to initiation of inhibition/extinction-based exposure therapies.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0166-4328 1872-7549
DOI:	10.1016/j.bbr.2021.113172