Most people can relate to a night spent tossing and turning, worrying about a job or a personal relationship. These situations are common, temporary, and usually only result in a bit of grogginess the next day. But what happens if the stress is chronic? Can stress cause sleep apnea, a common sleep disorder? Keep reading.

Can stress cause sleep apnea?

While stress may not be the primary cause of sleep apnea, there is plenty of evidence that it doesn’t help. Worse, both may exacerbate symptoms of the other.

Stress is an important biological response for situations that require quick action, but chronic stress negatively impacts our overall physical and mental health. If you have an excess of stress, it stands to reason that your sleep might be affected.

What’s the relationship between sleep apnea and stress?

While there may be no direct link between stress and sleep apnea, some conditions that contribute to the development of sleep apnea have their deep roots in long-term or chronic stress.

Generally, sleep apnea and the following conditions are considered bidirectional. This means that one affects and worsens the other. And while sleep apnea may not be a direct cause of these conditions, poor sleep can intensify the effects of each.

Bruxism

Bruxism (also commonly referred to as teeth grinding and jaw clenching) is a stress-related dental disorder. Of the estimated 25 million people in the U.S. with sleep apnea, 25% of them are also diagnosed with bruxism. This means that in addition to waking up in a haze of poor sleep, those with bruxism also experience the following:

  • Sore jaw
  • Headache
  • Clicking and popping in the temporomandibular joint
  • Development of TMD/TMJ (temporomandibular joint disorder)

A primary cause of bruxism is stress. An estimated 70% of bruxism is due to excessive stress or anxiety. The simple act of tooth grinding and the sudden increase in cardiovascular arousal mimics the same response the body has when it begins breathing again after an apneic pause in breathing.

Additionally, most bruxism occurs during the REM stage of sleep – the worst time for sleep apnea as well. Together, these two conditions feed off one another to make for a truly terrible night’s sleep.

Post-traumatic stress disorder (PTSD)

PTSD is a condition that mentally places a person back into a situation of previously experienced trauma. It does not matter if the trauma is well past, or if the person does not quite remember the trauma. Characterized by hypervigilance, irritation, anxiety, overreaction, and poor sleep, PTSD is a mental health condition that carries with it life-threatening consequences.

This type of stress and sleep apnea are clearly linked. For example, the stress of combat in Iraq and Afghanistan and the resulting PTSD made it the primary factor for increased risk of sleep apnea in 70% of veterans in a 2015 study. Further, the primary cause of sleep apnea for 76% of veterans in a 2018 study was PTSD after combat.

It’s important to note that anxiety is one of the major symptoms of those suffering from PTSD. If a person is diagnosed with sleep apnea, they are 18 times more likely to suffer from anxiety, as well.