The challenges of poor sleep are well-documented and many. From an increase in the risk of heart disease to a compromised immune system, poor sleep can impact all areas of your life. As awareness of the importance of paying attention to mental health increases, more attention is being paid to sleep apnea and anxiety. Here’s what you should know.
How many people with sleep apnea suffer from anxiety?
Sleep apnea, also referred to as sleep disordered breathing, affects an estimated 25 million people in the U.S. (although many people remain undiagnosed). There are three main types of sleep apnea.
- Obstructive sleep apnea: In this most common form of sleep apnea, breathing stops when the tissues of the throat relax down and back, obstructing the airway
- Central sleep apnea: The central nervous system “forgets” to send the signal to breathe
- Complex (or mixed) sleep apnea: A combination of the other two, the body “forgets” to breathe, but then when it attempts to inhale finds the airway blocked
Common symptoms of sleep apnea include daytime fatigue, headache or migraine, inability to concentrate, general irritability, and mood disorders.
Anxiety has become a catch-all phrase for a variety of mood disorders that can range in severity from mild to debilitating. In general, anxiety occurs when a person feels a restless sense of unease or foreboding. They may feel apprehensive and find themselves experiencing a variety of symptoms, including:
- Increased heartbeat
- Sweating
- Nausea and vomiting
- Gastrointestinal upset
- Difficulty concentrating
- Fatigue
- Rapid breathing
- Shortness of breath
- Continuous, unrelieved worry
Although results are not definitive, it does seem that people with obstructive sleep apnea in particular experience anxiety in higher levels than the general population, regardless of gender or age.
Can sleep apnea cause anxiety?
As with sleep apnea and depression, sleep apnea and anxiety disorder have a relationship that appears to be bidirectional. That is, one can influence the other in equal measure. People with sleep apnea are nearly 18 times more likely to have anxiety. And the more severe the sleep apnea, the more frequent are bouts of anxiety.
So why is this?
Poor sleep triggers anxiety
One of the hallmark symptoms of obstructive sleep apnea is the gasping intake of air that occurs when the brain triggers the breath response. Some sleepers may come awake suddenly, only to find themselves in the middle of a full-blown anxiety attack caused by their inability to draw breath and the brain’s natural reaction to that feeling of suffocation.
Research continues to connect excessive daytime sleepiness (EDS) – a symptom of obstructive sleep apnea – with anxiety. In one study, 51% of university students with EDS also presented with anxiety. This was compared to less than 31% of students without EDS.
Anxiety makes sleep difficult
Imagine you have a big presentation first thing Monday morning, something you are prepared for but already a little nervous about. By the time Sunday night rolls around, your anxiety is in full swing. It may come with a racing mind, shortness of breath, and an uneasy dread. It makes sense that sleep would be hard to come by. When sleep does come, the jittery quality of it may actually increase apneas.
Anxiety is actually a heightened state of arousal – possibly not even connected to a specific event – that acts on three areas of our bodies: behavior, hormones, and autonomic response.
Anxiety is what kept us alive when saber tooth tigers were hunting us. If the response is not shut off, though, the continued state of arousal can affect all aspects of life (including sleep). The stress response is a combination of behaviors in the body, a release of adrenaline and other stress hormones, and reflexive responses in the nervous system. This anxiety response can make finding any peaceful sleep nearly impossible.
While there is not a straightforward connection between anxiety and increased sleep apnea, research supports the idea that they are at least influencing each other.
The road connecting sleep apnea and anxiety disorder is there, but it is long, winding, and not always well understood.
How can treating sleep apnea help me manage my anxiety?
Because the relationship is bidirectional, treating one condition may help the other. Treating your sleep apnea can at least eliminate a physical cause of anxiety by keeping your airway clear and oxygen flowing into your brain and body all night long.
Starting with lifestyle changes can help, too. Obesity is a major risk factor for obstructive sleep apnea. Some sleepers find that exercise reduces their sleep apnea. Exercise is also recommended to help ensure a good night’s sleep, so that’s a huge benefit to both conditions.
Minimizing or eliminating alcohol before bed can also help treat both sleep apnea and anxiety caused by poor sleep.
You doctor may also recommend the use of a continuous positive airway pressure (CPAP) machine to treat obstructive sleep apnea. This device uses a mask fitted over the mouth and nose that delivers a steady stream of oxygen to keep the airway open. While this treatment is remarkably effective, it must be used every night.
If the noise and discomfort of the mask present a challenge, your sleep apnea dentist may prescribe a dental device for sleep apnea. This small night guard is custom fitted and holds your jaw slightly open. Some dental devices also prevent the tongue from sliding back and blocking the airway. For frequent travelers or those who need to sleep in a quiet room, a sleep apnea dental device can help.
Managing your anxiety can also help with your sleep apnea. Develop practices that promote stress reduction and a calm mind. These include meditating before bed, keeping a journal to write down whatever is on your mind before sleep, and maybe playing relaxing music to soothe racing thoughts.
Get help
At AZ Dentist, we understand the connection between sleep apnea and anxiety. If you suffer from one or the other, get in touch today to see how we can help.
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