Sleep Apnea and Anxiety

Did you know that sleep apnea can cause devastating effects on your body, especially your mental state? Some research studies indicate that symptoms of sleep apnea may potentially cause anxiety. Anxiety disorders affect approximately 40 million American adults, while sleep apnea affects about  22 million Americans.

If you're diagnosed with a sleep disorder such as sleep apnea, you may experience sleep disruption, leaving you exhausted when you wake up. And lack of enough sleep typically causes sleep deprivation, slow reflexes, fatigue, and inability to concentrate properly. So, if you aren't getting enough sleep, chances are you may also feel anxious. In addition, anxiety may also make you susceptible to panic attacks.

Sometimes, you may feel like your anxiety is spiraling out of control, especially when you've had a long day. But in reality, you may suffer from generalized anxiety disorder (GAD)—where insomnia keeps you up at night because of stress. Some studies indicate that sleep apnea and anxiety are closely linked, and they worsen each other's symptoms. So what's the relation between these two conditions? Let's dive in deeper to find out.

What's Sleep Apnea?

Sleep Apnea is among the most common sleep disorders that cause you to start and stop breathing repeatedly while asleep. Though there are many types of sleep apnea, obstructive sleep apnea is the most common one. Other two common types include central and mixed or complex sleep .

Central sleep apnea is primarily associated with the central nervous system. And it occurs when brain waves temporarily stop transmitting to the muscles controlling breathing. On the other hand, mixed or complex sleep apnea is a combination of both central and obstructive sleep apnea. However, its occurrence is sporadic among sleep apnea patients. 

Often, sleep apnea episodes may jolt you awake due to a lack of enough oxygen supply during sleep. These jolts are usually brief, and you hardly remember them. Experiencing this sleep disruption in your natural sleep rhythm means you spend less time in deep sleep and more in light sleep. Deep sleep is the restorative shut-eye required to wake up feeling rejuvenated and energized. 

Aside from sleep issues, sleep apnea may also come along with health issues like breathing problems. Worst-case scenario, some health problems may be deadly. You should seek treatment immediately. Also, you need to talk to your doctor if you suspect your sleeping partner has obstructive sleep apnea.

Signs and Symptoms of Obstructive Sleep Apnea

It's unlikely that you'll notice your first symptoms of obstructive sleep apnea. However, your sleeping partner may inform you about some of the most common signs, which may include;

  • Dry mouth and sore throat upon waking up
  • Forgetfulness and short concentration span
  • Waking up frequently at night to go pee
  • Sexual dysfunction
  • Headaches
  • Anxiety and depression
  • Daytime sleepiness and fatigue
  • Night sweats
  • Snoring loudly

Signs and Symptoms of Central Sleep Apnea

Central sleep apnea patients usually experience chronic insomnia or wake up frequently at night. Like patients with obstructive sleep apnea syndrome, individuals with CSA may also experience a gasping or choking sensation upon waking up. Common signs and symptoms include;

  • Poor performance in school-going children
  • Breathing through the mouth
  • Heavy night sweats
  • Bedwetting
  • Difficulty swallowing
  • Trouble staying asleep till morning
  • Unusual sleeping styles and positions
  • When inhaling, the ribcages move inwards

Causes of Central and Obstructive Sleep Apnea. 

Some of the conditions which propel OSA prevalence are;

  • Lung diseases like pulmonary fibrosis and asthma
  • Kidney or heart failure may cause gradual fluid buildup in the neck, obstructing upper airway airflow
  • Neuromuscular diseases like stroke may block the brain waves from transmitting to the airway and chest muscles
  • OHS (obesity hypoventilation syndrome)—common among obese people

Central Sleep Apnea Causes

Typically, central sleep apnea primarily occurs as a result of conditions impairing the brain stem. The brain stem connects to the spinal cord to the entire body to control functions like breathing and heart rate. Factors that may damage this link include;

  • Heavy reliance on prescribed opioids
  • Medical conditions like kidney disease
  • Congestive heart failure
  • CPAP machine (but very rare)

What is Anxiety?

Anxiety is usually how the brain reacts to inform you of any potential danger. Though a normal emotion, anxiety can morph into a medical condition in cases of disproportionate levels. The disorder is commonly associated with feelings of worry, stress, tension, high blood pressure, and even physical changes.

Notably, there are many types of anxiety disorders. These disorders form a group of mental health diagnoses that lead to fear, worry, nervousness, and apprehension. Anxiety disorders may alter a person's brain activity, changing how they perceive and process emotions. While a mild anxiety disorder may be vague, a severe form can significantly affect your daily life and routines.

Though anxiety disorders affect about 13% of the US general population, only 39% of patients with anxiety disorders receive proper diagnosis and treatment. The condition can cause distress, but it's not often considered a medical condition. Like sleep apnea, there are many types of anxiety disorders; 

Anticipatory Anxiety

Anticipatory anxiety is the fear of negative future outcomes. Generally, anticipatory anxiety is commonly associated with high levels of overwhelming anxious feelings about future events. In most instances, there are normal levels of concern about future outcomes, which is acceptable. However, with anticipatory anxiety, you may experience debilitating levels of concern and worry about the future, focusing primarily on negative results. Individuals with anticipatory anxiety may be highly anxious for days, weeks, or months before the anticipated event. 

Generalized Anxiety Disorder (GAD)

Both children and adults can develop this type of anxiety disorder. GAD makes a person unrealistically tensed and worried, even without any feelings to trigger it. Some of GAD's symptoms are similar to other conditions like obsessive-compulsive disorder, some anxiety disorders, and panic disorder. For instance, difficulties concentrating during the day and staying asleep at night, constant restlessness, and others. 

Depending on the status of the condition, GAD is, at times, categorized under psychiatric disorders. Some people with this condition must undergo psychotherapy and medication to improve their symptoms. Relaxation techniques, making lifestyle adjustments, and learning coping skills can also help improve GAD significantly.

Panic Disorder

A panic disorder is commonly characterized by recurring panic attacks and constant fear. Common signs and Symptoms of panic attacks include; increased heart rate and overwhelming fear or dread for no apparent reason—At times, it may cause physical issues such as breathing difficulties.

Though panic disorder may have overwhelming symptoms, proper treatment can help reduce the symptoms and boost overall life quality. Other signs of a panic attack are; dizziness, nausea, lightheadedness, shaking, fear of death, and chest pain.

Phobias—Fear of Certain Situations or Objects

People with Phobias usually experience panic attacks and a deeper sense of dread when fear sets in. The fear of objects and situations is typically connected to something specific, unlike anxiety disorders. Phobia impacts can either be extensively disabling or just plain annoying.

Though phobia patients may realize how irrational their fear is when an episode sets in, it usually goes beyond their control. These fear can tamper with a person's relationships, work, and school life.

Causes of Anxiety

As already mentioned, anxiety is an emotional response people experience from time to time. Some of the common causes and triggers include; 

Sleep Deprivation

Not only can sleep deprivation cause anxiety, but it can also worsen it. According to a sleep study by the CDC (Centers for Disease Control and Prevention), adults should get at least 7 hours of quality shut-eye daily.

Other studies investigating sleep deprivation and anxiety have established a link between them. The evidence shows that a sleep-deprived person with an anxiety disorder is more likely to suffer high anxiety levels than an individual without any anxiety disorder. 

The link between these two conditions can lead to a vicious cycle. This is clearly defined in a sleep study by the Anxiety and Depression Association of America—meaning sleep deprivation causes anxiety, and then anxiety causes sleep problems. Notably, sleep-deprived people are usually more sensitive to the anxiety-inducing effects of stimulants like caffeine.

Physical Health Problems

Another potential cause of anxiety is chronic physical issues, impact on anxiety treatment, or treatment of the physical problem. Common forms of chronic physical issues typically associated with anxiety are;  

  • Heart disease
  • Hypertension
  • Asthma
  • Diabetes

Other physical issues like overactive thyroid can potentially mimic an anxiety disorder. In such situations, it's best to see your doctor immediately to assess whether or not your feelings of anxiety are medical.

Alcohol and Drug Abuse

According to this medical study research, people with anxiety are triple times more likely to struggle with alcohol and drug abuse than the general population. The ADAA (Anxiety and Depression Association of America) also points out that alcohol and drug abuse can cause panic attacks.

Individuals with social anxiety may consume more alcohol to reduce anxiety symptoms. The fact is alcohol worsens anxiety more than it lessens it. Since about 20% of individuals with social anxiety disorders struggle with alcohol and substance abuse—the combination of these substances and anxiety may become a never-ending vicious cycle.

Other causes of anxiety include;

  • Mental health conditions like depression
  • Heart problems
  • Some medications, such as over-the-counter decongestants, asthma, and thyroid drugs
  • use of weight loss supplements.
  • General stress

General Anxiety symptoms

Though signs and Symptoms of anxiety may vary depending on the type of anxiety disorder, some general ones include;

  • Heart palpitations
  • Muscle tension
  • Shortness of breath
  • Sweaty hands
  • Inability to stay calm
  • Obsessive thoughts
  • Fear, panic, and uneasiness
  • Repeated flashbacks and thoughts of past traumatic events

The Link Between Anxiety and Sleep Apnea

One common feature both anxiety and sleep apnea share is that they are linked to sleep. According to most studies, both anxiety and sleep apnea are two co-occurring conditions—with some evidence indicating they exacerbate each other.

Fatigue and daytime stress are clear signs of sleep disturbance due to sleep apnea. So, not only can anxiety trigger but also worsen sleep apnea, making it difficult to fall asleep at night.

Anxiety and Depression Association

A particular study revealed anxiety to be more prevalent among people with obstructive sleep apnea. Even worse, OSAS patients with severe cases of this sleep disorder were at a higher risk of experiencing high anxiety levels. More importantly, the study also noted anxiety and depression association among sleep apnea patients with both anxiety and depression.

Overall, several studies concurred with the results. They stated that anxiety and depression prevalence was primarily higher in patients with sleep apnea than those without.

Treating Sleep Apnea and Anxiety

Though anxiety may heighten your sleep apnea, it doesn't cause sleep apnea, at least not directly. That's why most researchers recommend treating sleep apnea and anxiety separately. The most recommended sleep apnea treatment option is with the aid of a CPAP (continuous positive airway pressure) machine. 

The machine is a small breathing equipment with a face mask that you wear when going to sleep. Upon wearing this mask, it'll create efficient air flow into your lungs, allowing you to achieve deep restorative sleep. More importantly, it also ensures you stay asleep, so you don't wake up frequently in the middle of the night. 

Once you're getting sufficient deep sleep, your body will immediately start recovering. So, you no longer have to worry about sleep deprivation or fatigue since cortisol levels in your brain shall have reduced when you wake up. 

Overall this mode of treatment should also decrease your anxiety levels and general moodiness. However, if anxiety symptoms persist after treating sleep apnea, consult your doctor to recommend you the best treatment options for anxiety and stress.

Closing Thoughts

Both anxiety and sleep apnea are serious conditions you shouldn't take lightly. If you suspect that you have both anxiety and sleep apnea, or that one is causing the other, you can adopt and practice good sleeping habits such as getting proper physical exercise during the day, sleeping in a dark room, and having a consistent bedtime routine. 

Anxiety and sleep apnea share many similar symptoms making it relatively easy to mistake one for the other—for instance, insomnia and fatigue. The frequent jolts your body experiences at night may give the brain a hard time dealing with stress. That's why it's imperative to take quick action to improve your sleep health. So, in instances where you suspect symptom similarities mentioned above, consult with your doctor immediately or take In-Home Sleep Test.

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