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Post-traumatic stress disorder (PTSD) occurs in some individuals that are exposed to emotionally disturbing events such as combat, rocket, and terrorist attacks. Individuals that have suffered traumatic brain injury (TBI) or experienced natural disasters and sexual assault are also at higher risk of having this disorder.

Symptoms may include quality of life issues such as explosive outbursts of anger, difficulties in concentrating, being easily startled, feeling constantly “on guard”, expecting a threat to occur at any moment, depression, problems sleeping, avoiding people and circumstances that can trigger unpleasant memories or outbursts, limiting emotional relationships, and avoiding crowded locations.

Up to twenty percent of veterans serving in Iraq and Afghanistan, 10% of Gulf War (Desert Storm), and 30% of Vietnam Veterans have been diagnosed with post-traumatic stress disorder.

PTSD is not only a psychiatric issue. Individuals suffering with PTSD are at higher risk of being physically ill, and at increased risk of death from a multiple of causes.

PTSD is Associated with Inflammatory Responses.
Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.

A combination of high blood sugar, cholesterol, and blood pressure, coupled with excess fat around the abdomen (abdominal visceral fat), increases the risk of individuals for stroke, heart disease, and diabetes. This cluster of symptoms, metabolic syndrome, is associated with inflammation and is found in 48% of individuals with post traumatic stress syndrome compared to 25% of controls. Such clinical issues result in patients with PTSD utilizing a greater proportion of medical services and prescription medications.

IL-6 is a cytokine, an immune messenger, which plays a major role in inflammation, helping the body heal after tissue injury, and defending the body from pathogens. C-reactive protein (CRP) is another biological marker that is strongly related to heightened levels of inflammation. Elevated levels of IL-6 and CRP are associated with an increased risk of heart attacks and other cardiovascular events that are inflammatory in nature.

Reports of increased presence of inflammatory cytokines in individuals with PTSD are inconsistent. However, the evidence suggests in military personnel with PTSD or depression, IL-6 levels are higher than found in control subjects, and that the quality of life of these soldiers is poorer as well. Similarly, individuals with PTSD are more likely to have significantly higher amounts of circulating CRP than those not diagnosed with PTSD.

Intermittent explosive disorder is one of the more troubling aspects of some individuals with post traumatic stress disorder. This condition involves repeated episodes of impulsive, angry, verbal outbursts, and violent and aggressive behavior. CRP and IL-6 levels are significantly higher in personnel with intermittent explosive disorder compared with normal or other psychiatric controls, suggesting a direct relationship between inflammation and aggression.

Summary:
Fifty percent of individuals with post traumatic stress syndrome do not seek treatment, and of those that do, only half of these persons will get “minimally adequate” treatment. Until now, the primary treatments for PSTD are psychological counseling and psychiatric medications.

Inflammation is the result of a delicate balance between inflammatory and anti-inflammatory responses, and the body constantly strives to maintain a state of “immune homeostasis”, immune balance.

As in most disease, chronic low-grade inflammation is a likely contributor to post traumatic stress syndrome. If individuals with PTSD better controlled the amount of inflammation produced by their bodies, their quality of life would improve, both emotionally and physically.

 

There is no cost to speak with Dr. Hellen. She can be reached at 1.302-265.3870 ET [USA] or contacted at: drhellen@drhellengreenblatt.info.

 

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Obstructive sleep apnea syndrome  (OSAS) occurs when an individual repeatedly stops breathing, sometimes as many as 1-2 times a minute during their sleep.  It is most frequently associated with heavy snoring, broad swings in heart rate, and, as one would expect, extreme daytime sleepiness.  Those that suffer with sleep apnea are prone to accidents; they are twice as likely to be involved in car crashes as compared to individuals without the condition.

 The relationship between inflammation and sleep apnea is complicated, with not only inflammation of the airways, but  body-wide inflammation as well.

 As with other inflammatory conditions, obstructive sleep apnea is associated with cardiovascular disease, diabetes, and obesity.  Visceral fat, belly fat, is a major predictor of having obstructive sleep apnea syndrome, since fat cells produce large amounts of immune modulating molecules, that trigger inflammation.

 People suffering with sleep apnea have complex imbalances of immune factors, cytokines.  Their levels of immune modulating cytokines, such as tumor necrosis factor and interleukin (IL)-6, are markedly high, as are levels of other inflammatory proteins, including  C-reactive protein (hsCRP). [CRP is a blood protein typically associated with the presence and amount of inflammation in the body.]  Additionally,  hormones that regulate insulin and hunger levels are higher than levels found in those without sleep apnea.

 There is conflicting data about the affect of CPAPs, continuous positive airway pressure breathing devices,  on inflammation. Some studies suggest that the devices help lower the number of inflammatory molecules circulating in the body, other studies suggest that using a CPAP increases inflammation.

 Successfully battling disease, and healing , is determined by inflammatory immune cells and the types and ratios of cytokines they generate.  Restoring balance, immune homeostasis, to the body, helps the body stay healthy, and recover rapidly when in ill health.

emedicine.medscape.com/article/295807-overview
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www.mayoclinic.com/health/sleep-apnea/DS00148
www.ncbi.nlm.nih.gov/pubmed/22408197

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