The Connection Between Sleep Apnea and Anxiety

Sleep apnea is a serious sleep health issue affecting over 30 million adults in the US. It shares common symptoms with anxiety disorders which affect over 40 million adults, according to the Anxiety & Depression Association of America. While sleep apnea and anxiety often occur concurrently, stress may be the common link between the two disorders.

Symptoms and Challenges in Diagnosis

Sleep apnea, and its most common form, Obstructive Sleep Apnea (OSA), is a type of sleep-disordered breathing caused by muscles that relax during sleep, resulting in blocked upper airways. Sleep apnea is defined by breathing that intermittently starts and stops throughout the night. People who suffer from sleep apnea have symptoms including excessive daytime fatigue, lack of mental acuity, morning headaches, and irritability.

General Anxiety Disorder (GAD) is characterized by excessive worry that affects daily life and includes physical symptoms of restlessness, fatigue, difficulty focusing, and disturbed sleep.

The crossover with sleep apnea symptoms makes distinguishing between the two conditions difficult, resulting in the need for a diagnosis to define further and treat the disorder(s). Both sleep apnea and anxiety are growing in prevalence yet are underdiagnosed. It is estimated that 80% of sleep apnea cases go undiagnosed each year.

Similarly, anxiety disorders are now the most common mental illness in the US. While the conversation around mental health is growing, there is still a stigma associated with getting treatment, with only around 40% of those affected getting the care they need.

The Role of Stress and Co-occurrence

A limited study during the pandemic linked overly stressed medical workers in Wuhan with a 50% higher risk of sleep apnea. This study was small, and its conclusions did not include any mechanism explaining the link between stress and sleep apnea. The most important takeaway from this study is that these conditions occur together with frequency. Stress is a trigger for anxiety, and specific forms of anxiety, such as PTSD, have been scientifically linked to OSA.

Research has shown that sleep apnea in its most severe forms does have a link to concurrent depression and anxiety. Some researchers theorize that after a positive diagnosis, the stress from learning you have sleep apnea may cause further anxiety, creating an endless cycle between the two issues.

Additionally, the mental fogginess accompanying sleep apnea may make it more difficult to handle daily stresses, again confirming the frequency of co-morbid mental health issues with this sleep health condition. While the relationship may not be causal, the frequency of occurrence between sleep apnea and anxiety warrants further study.

Importance of Diagnosis, Treatment, and Overall Well-being

The first step to determine if you have sleep apnea is to have a sleep study done. Sleep studies can conveniently be done at home, overnight. By wearing a home sleep testing device, data is gathered on blood oxygen level, heart rate, and breathing during sleep. While a sleep study won’t diagnose a mental health condition, it can detect whether or not you have sleep apnea, putting you at greater risk of co-morbid mental health issues.

Evidence shows that each condition can make the other worse, so discussing any symptoms of stress or anxiety in addition to sleep issues with your doctor is also essential for further diagnosis. Because sleep apnea is linked to other serious health co-morbidities such as cardiovascular disease, hypertension, and even diabetes, it is important to seek diagnosis and treatment. Ultimately, sleep health is critical to both your physical and mental well-being.