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The Link Between Sleep Apnoea and Anxiety

Benefits Of Sleep

The Link Between Sleep Apnoea and Anxiety

An increasing number of studies indicate a link between sleep apnoea and anxiety. Sleep apnoea is a debilitating disorder which causes sleep deprivation and prevents the body from receiving the restorative sleep it requires. 

Obstructive sleep apnoea is the most common form of the disorder and can see a sufferer waking multiple times every night as their airways narrow and the brain prompts the body to wake up for air. Factors such as obesity, age, smoking and excessive alcohol consumption can put someone more at risk of developing sleep apnoea.

The majority of people with sleep apnoea remain unaware they have the disorder, but it can lead to serious health issues when left undiagnosed. These include:

  • Heart disease
  • High blood pressure
  • Stroke
  • Type 2 diabetes
  • Liver damage
  • Depression

Sleep deprivation from sleep apnoea also leads to fatigue, putting you more at risk of road accidents, as well as poor concentration and mood issues. A lack of sleep places stress on the body and the mind and since anxiety is the body’s way of reacting to stress it should not be a surprise if there is a link between sleep apnoea and anxiety.

Sleep Apnoea and Anxiety

A 2012 European study found that over half the people reporting sleep disorders such as sleep apnoea also reported suffering a level of depression or anxiety. 

Although having one condition does not automatically mean you have the other, it does makes sense that someone with sleep apnoea is at higher risk of anxiety. 

Each interruption to your sleep caused by sleep apnoea adds to what is termed as your sleep debt. This cumulative sleep deprivation can make it harder for the brain to deal with stress — as it’s on top of the extra stress felt by the body when it is not receiving the restorative sleep it needs. 

Since anxiety is a reaction to stress, it makes sense anxiety levels increase if you have sleep apnoea. If someone is already experiencing anxiety, sleep apnoea will likely aggravate the condition further. 

In other words, according to Carolyn at Sleep Advisor, “sleep deprivation can cause anxiety and depression and anxiety and depression can cause sleep deprivation. So, it’s basically a vicious cycle. Depression can increase fatigue and longterm sleep disruption can ultimately disturb circadian rhythms.”

A study conducted by the University of Pennsylvania reported people who had their sleep limited to just 4.5 hours each night were consequently feeling more stressed and mentally as well as physically exhausted. 

This tallies with the known effects of sleep apnoea where sufferers struggle with poor concentration levels and irritability brought on by fatigue from sleep deprivation. The apnoeas which interrupt sleep can also induce panic attacks and anxiety at the time of their occurrence as they can result in people waking up during the night gasping for air.

Can Anxiety Cause Sleep Apnoea?

Although there is a strong correlation between the two conditions, having anxiety does not automatically mean you will have sleep apnoea. 

While sleep apnoea may increase the risk of increased anxiety there is little evidence to date to suggest anxiety can lead to sleep apnoea. However, anyone who has gone to bed anxious with plenty on their mind knows how difficult it is to sleep. 

So while anxiety may not necessarily be a factor in developing sleep apnoea it could very well hinder treatment for the sleep disorder. There are a number of treatment options for the most common form of the disorder, obstructive sleep apnoea, which all focus on reducing the potential for the apnoeas to occur and ensuring consistent good quality sleep. 

Only by restoring uninterrupted sleep and reducing the sleep debt can the symptoms of sleep apnoea be removed. Since anxiety can be prohibitive to sleep it can make treatments for sleep apnoea less effective.

Testing and Treatment for Sleep Apnoea

The damaging effects of sleep apnoea, including additional stress and anxiety, can only be addressed once the disorder has been diagnosed. It is estimated in America alone 18 million people have sleep apnoea, yet it is also reckoned that up to 80% of cases remain undiagnosed. 

As well as fatigue, irritability and poor concentration levels, other symptoms of sleep apnoea are heavy snoring, morning headaches and a dry mouth. Often these symptoms can be mistaken for other conditions. However, if you are experiencing symptoms associated with sleep apnoea it is important to get tested for the disorder.

In-home Sleep Apnoea Testing

Simple to use sleep apnoea tests can be completed from the comfort of your own home. The test involves wearing a device on your finger for a couple of nights while you sleep — which recording your breathing and blood oxygen level. 

Once done, you return the device and a qualified sleep physician will analyse the data. 

An in-home test is usually the first step toward diagnosis from where your doctor can recommend the treatment method best suited to address the degree of sleep apnoea you are experiencing, which can range from mild to moderate or severe.

Treatment options can include lifestyle changes if excess weight is a factor, as well as adjustments to your sleeping environment to help encourage sleep. 

Sleeping on your back will cause sleep apnoea symptoms, as gravity can pull the throat tissues down, causing it to block airways. Your doctor may advise trying positional therapy, which involves wearing a device around the waist or on the back to prompt your body to roll over on its side.

An oral device may also be used which can resemble a sports mouthguard and are designed to keep the airways open as you sleep. Continuous positive airway pressure (CPAP) therapy is a leading treatment for obstructive sleep apnoea and uses a device to gently force air in to the airways as you sleep.

Consult With Your Doctor

Symptoms of sleep apnoea and anxiety can be similar but the important point is if you are experiencing such symptoms you should consult your doctor as soon as possible. 

Treating sleep apnoea can help reduce stress and anxiety levels as well as decrease the risk of developing a number of other serious health problems. Both conditions may well feed off the other, but only by testing and diagnosis can you receive the professional help required to reduce the symptoms of sleep apnoea, improve your sleep, improve your mood and reduce your anxiety levels.

To order an In-Home Sleep Apnoea Test:



About author: Helen Clarkson is a Sleep Specialist at Baywater Healthcare. Ms. Clarkson has worked with Baywater since 2008, working closely with patients in delivering sleep/bi-level services including sleep and respiratory, both in the home and clinic setting. This includes therapy initiation and troubleshooting support. Ms. Clarkson is responsible for delivering the Baywater Healthcare patient adherence management programme to ensure continuing patient therapy compliance. works in conjunction with NHS clinicians and procurement to deliver excellence in home and clinic-based services. She provides training on all aspects of sleep including devices and interfaces. Previously, Ms. Clarkson served as Respiratory Physiologist at Pontefract General Infirmary. Her position was Senior MTO for lung function/sleep department, and she was responsible for performing simple and complex sleep studies, sleep study analysis, CPAP initiation, therapy adherence and troubleshooting/service clinics, spirometry, lung volumes and transfer factor, reversibility, CPET, hyperventilation testing, EIA testing, skin prick testing, 6 min walk tests. She has also held roles as Respiratory Physiologist and Respiratory Technician, working closely with patients with respiratory disorders -- including ex-miners. Ms. Clarkson has a BSc (Honors) in Applied biology from University of Staffordshire. She also studied Developments in Sleep Medicine (advanced course) at St. Thomas’ Hospital, and took the Edinburgh Sleep Medicine course. She completed the BSS: Advanced sleep course and the ARTP NIV Course.

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