It’s well known that sleep apnea — the sleep disorder that causes pauses in breathing while you sleep — can negatively impact your physical health. But what about its effect on mental health?
Though the relationship is complex, there is a correlation between sleep apnea and anxiety. Below, we’ll cover how sleep apnea and anxiety impact one another, who’s most at risk for developing anxiety, when to talk to your doctor, and common questions about sleep apnea and anxiety.
Does Sleep Apnea Cause Anxiety?
While sleep apnea doesn’t directly cause anxiety, there’s a strong association between the two. Research has shown higher rates of anxiety among those with sleep apnea, with one study reporting anxiety in nearly 17% of its participants.
It’s not entirely known why the correlation between sleep apnea and anxiety exists, but several theories exist based on what we know about sleep.
- Fragmented sleep: Sleep apnea causes small awakenings during the night, which can wreak havoc on sleep quality. And because sleep is the time when we process emotions, interrupting that process can lead to heightened anxiety.
- Neural changes: There’s some research to show that sleep apnea can actually alter neural pathways in our brains in areas that control both respiration and emotion. Experts think it might have something to do with lack of oxygen during apneic events.
- Increased stress: People with sleep apnea tend to also experience higher levels of stress. When you momentarily stop breathing or struggle for air, your body’s fight-or-flight system is activated, and there’s a strong overlap between stress and anxiety.
It’s also worth noting that sleep apnea and anxiety share a bidirectional relationship, meaning that they impact one another. Sleep apnea impacts sleep quality, which, in turn, worsens anxiety symptoms. Anxiety can make it more difficult to sleep, which can also exacerbate sleep apnea.
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Can Anxiety Cause Sleep Apnea?
Anxiety can’t actually cause sleep apnea, but it can make it worse. Anxiety is highly linked to insomnia; symptoms like racing thoughts and excessive worrying can make it difficult to fall asleep and stay asleep. This interrupted sleep can then worsen the effects of sleep apnea.
Anxiety can also impact CPAP adherence. Continuous positive airway pressure (CPAP) therapy is the most common and effective treatment for sleep apnea and involves wearing a mask while you sleep through which pressurized air is delivered to keep your airway open. Some people with anxiety experience claustrophobia while wearing a CPAP mask and thus have a hard time using their CPAP machine consistently.
There’s some evidence that having anxiety might increase a person’s risk of developing sleep apnea, because anxiety acts on some of the same parts of the brain that regulate respiration. More research is needed to establish a definite link.
Who Is Most at Risk?
Individuals who have untreated sleep apnea and those with insomnia and/or preexisting anxiety are most at risk of experiencing anxiety symptoms.
- Untreated sleep apnea: If left untreated, the effects of poor sleep quality can add up over time, increasing your likelihood of developing anxiety.
- Insomnia: Sleep apnea, insomnia, and anxiety are all interrelated. Sleep apnea can make it difficult to fall or stay asleep, the hallmark symptoms of insomnia. The lack of sleep associated with both can contribute to anxiety. What’s more, people with insomnia sometimes develop anxiety about sleep.
- Preexisting anxiety: If you’ve already been diagnosed with anxiety, sleep apnea is likely to worsen your symptoms.
Does Treating Sleep Apnea Help Anxiety?
Sleep apnea treatment isn’t a cure for anxiety, but it may help relieve your symptoms. Some studies have shown that CPAP therapy, when used correctly, can lead to a reduction in anxiety over time. That’s because improved sleep quality can help with mood regulation.
When it comes to sleep apnea and anxiety, combined care is key. It’s important to treat your sleep apnea with CPAP therapy and to simultaneously treat your anxiety through mental health care, like medication and/or therapy.
When to See a Doctor
If you experience any symptoms of sleep apnea — including loud snoring, choking, and daytime sleepiness — it’s time to talk to your doctor about testing for sleep apnea. Irritability and mood changes are also overlooked symptoms of sleep apnea. If you find yourself feeling sleep deprived and anxious, it’s possible that your sleep apnea is contributing to symptoms of anxiety.
If you continue to have symptoms of anxiety even after sleep apnea treatment, talk to your doctor about anxiety medication and/or therapy.
Frequently Asked Questions
Is anxiety a symptom of sleep apnea?
Irritability and feelings of anxiety can be symptoms of sleep apnea, though they’re often overlooked, especially in women with sleep apnea. It’s important to distinguish, though, between normal feelings of anxiety that everyone experiences and anxiety that’s so bad that it interferes with everyday life. If you’re experiencing a lot of anxiety that persists for more than a few weeks, it’s important to speak to a doctor to see if treatment is necessary.
Can sleep apnea cause panic attacks?
Though rare, it’s possible for sleep apnea to lead to panic attacks. Sleep apnea can cause people to wake up choking or gasping for air, which can trigger a panic attack. Sleep apnea can also change brain structure over time, increasing a person’s risk of developing a panic disorder.
Does CPAP help anxiety?
While CPAP isn’t a cure for anxiety, it can help reduce anxiety symptoms. CPAP allows those with sleep apnea to receive continuous airflow, eliminating awakenings due to lack of air. Improved sleep quality can help individuals better regulate their emotions and manage their anxiety.
Can lack of sleep trigger anxiety?
Lack of sleep can trigger increased anxiety because sleep deprivation impacts brain functioning in the areas that impact emotional regulation.
