It is estimated that the prevalence of post-traumatic stress disorder (PTSD) for veterans and active-duty service members range from a low of 7% to a high of 20% depending on the study and methodology used. But regardless, the level is significantly higher than the general population. PTSD and its associated disorders such as severe anxiety, claustrophobia, or substance use can be a challenge to treat for clinicians because of how it effects or limits the tools we typically use for diagnoses or treatment. A 76-year-old retired Army Master Sargent (MSG) initially presented for dizziness resulting in a fall. He was found to be in septic shock requiring pressors to maintain blood pressure over 100 systolic. He was admitted to the medical intensive care unit (MICU) and was found to have respiratory acidosis with a pH 7.21 and CO2 75.5. It was determined that he had severe obstructive sleep apnea that required a CPAP, but refused to wear it because of severe claustrophobia and PTSD. The event surrounding his claustrophobia involved a motor vehicle accident, while in SCUBA equipment while on a mission. Throughout his hospital course, the patient refused respiratory treatment such as BiPaP, nightly CPAP, and imaging to include MRI and CT scans. During once such incident, where there were concerns for a stroke given new onset altered mental status and an right atrial/superior vena cava, he refused to be placed in the CT scanner. He stated, “If I die, I die.” Later that night, a code blue was called after he was found to be in PEA cardiac arrest with brain imaging that showed new hypodensity in the left posterior capsule. It was determined that the patient experience respiratory arrest after a VBG showed a pCO2 83.4. He was transferred to the MICU where he stayed until his death. While in the MICU, he refused respiratory treatments because he was unable to tolerate the BiPAP because of his severe claustrophobia. Imaging requiring sedation by anesthesia which was risky because he was hypotensive throughout his admission with a SBP averaging in the 110’s and DBP in the 50’s. Pressors were often required post imagining. Psychiatry was consulted to help manage his PTSD and claustrophobia in the acute setting but given this disorder can take a lifetime to properly manage and treat; they had limited success, and the treatment team was only able to provide BiPap treatment while using Precedex. One night he aspirated while on BiPaP and because he was on Precedex was unable to protect his airways. He was intubated and died shortly after being extubated. This case illustrated how the patient’s underlying PTSD may have contributed to a bad outcome and in general, the challenges health providers encounter in treating our veterans and service members who have PTSD and the associated disorders. Thus, more research is warranted to improve the care of veterans and active duty service members who are plagued by PTSD and other service related psychiatric disorders.