If you are one of the 25% of people in the U.S. who suffers from insomnia, you know how frustrating it can be to toss and turn all night long. If you also suffer from sleep apnea, your frustration may lead to even more restless nights. Sleep apnea and insomnia are deeply connected. Here’s how.

What is sleep apnea?

Sleep apnea is a type of sleep disordered breathing that occurs in an estimated 25 million people in the U.S. This estimate is misleading, as some researchers believe that 80% of cases may be undiagnosed.

There are three types of sleep apnea.

  1. Obstructive sleep apnea (OSA): OSA is the most common type of sleep apnea; the muscles of the throat relax back during sleep, blocking the airway
  2. Central sleep apnea (CSA): CSA occurs when the brain essentially forgets to trigger the breathing reflex
  3. Complex sleep apnea: Complex sleep apnea occurs when the airway is blocked by the muscles of the throat, but the brain also does not trigger the breathing reflex

Each of these types of sleep apnea can have serious effects on your everyday life. Those who suffer from any type of sleep apnea report daytime sleep apnea symptoms like difficulty focusing, irritability, fatigue, and morning headache.

There are also significant health risks that occur in people with sleep apnea, including increased risk of the following:

Untreated sleep apnea can even lead to death.

What is insomnia?

Insomnia is a sleep disorder that can show up in different ways at night. Just like sleep apnea, there are three types of insomnia.

  1. Trouble falling asleep: People with this type of insomnia may toss and turn for hours every night before they are able to fall asleep
  2. Early waking: Waking up in the middle of the night and being unable to fall back asleep is the hallmark of this type of insomnia
  3. Poor sleep: Poor sleep may be a combination of the first two types of insomnia, or it may just be a sleeper who is unable to sleep deeply

It is difficult to properly identify the number of people who suffer from insomnia because, just like sleep apnea, many cases go undiagnosed. The range of estimated prevalence of insomnia is between 6% and 30% of people in the U.S.

What causes insomnia?

Insomnia is sometimes caused by what is called hyperarousal. This is when the brain becomes particularly active. Essentially, it cannot slow down enough for sleep.

Other potential medical causes of insomnia may include:

  • Nasal and sinus allergies
  • Gastrointestinal problems (e.g., acid reflux or heartburn)
  • Endocrine issues (e.g., hyperthyroidism)
  • Arthritis
  • Asthma
  • Neurological conditions
  • Chronic pain, such as low back pain

Medications can also cause insomnia, as can other physical conditions such as restless legs syndrome.

It is important to note that while many conditions may cause a period of poor sleep, it is not technically diagnosed as insomnia until a person has experienced disrupted sleep for three months or more.

Can sleep apnea secondary to insomnia occur?

The short answer is yes: sleep apnea secondary to insomnia can and does occur regularly. Sleep apnea and insomnia are both classified as one of the more than 80 sleep disorders. Research indicates that sleep disorders are often comorbid; that is, they occur in conjunction with one another.

A study in 2018 found startling results on the significant connection not only between sleep apnea and insomnia but the effect of both on a person’s health. This study found that nearly 30% of patients with obstructive sleep apnea suffered from insomnia, with women experiencing it more frequently than men. Patients with both OSA and insomnia also had nearly triple the rate of heart disease than did the group with no insomnia.

Other reviews of literature and studies note that these two conditions are often frequently worse together than they are separately. These two conditions feed each other, and both in turn decrease a person’s quality of life and increase daily impairment.

Insomnia used to be considered a secondary condition to another disease or disorder but now has its own designation. This shift in how we recognize insomnia has also colored the way we diagnose sleep apnea in relation to it.

One study found that as many as 69% of people with insomnia also suffer from some degree of sleep apnea. And if you think this number is high, consider the observation by researchers that this 69% is probably a low estimate.

How to treat sleep apnea and insomnia

Perhaps the first and most important treatment for both conditions is to make lifestyle changes that support overall good health. Losing weight by diet and exercise is one change that can make a big difference.

Obesity is a primary risk factor for sleep apnea, and there are many studies that show that exercise can go a long way towards treating insomnia. Maintaining a healthy BMI can also ease sleep apnea and prevent it from worsening (and in some cases eliminate it altogether).

Learning how to deal with or eliminate stress in your life can also help treat both sleep apnea and insomnia. Insomnia is often caused by stress and an inability of the mind to shut off and sleep. The pauses of breath in sleep apnea produce a stress response in the body that can exacerbate this condition. Meditating, doing yoga, or simply walking in nature (forest bathing) can help ease daily stress to help you get a better night’s sleep.

For severe OSA, CPAP machines are often literal lifesavers. However, one of the most troubling aspects of sleep apnea and insomnia treatment is that insomnia can reduce CPAP compliance. This may occur because patients who struggle to fall asleep may not feel comfortable with the mask of a CPAP machine and decide to sleep without it.

Fortunately, there are other CPAP alternatives that can help. Sleep positional therapy, sleep apnea oral appliances, and sleep apnea pillows can help sleepers with mild to moderate sleep apnea find comfort and rest.

AZ Dentist is your sleep apnea dentist in the Phoenix area. We know how challenging sleep apnea and insomnia can be. If you struggle to get a good night’s sleep, get in touch today. With everything from at-home sleep apnea tests to dental devices for sleep apnea, we can help.