does anxiety make sleep apnea worse?

There is no doubt about the catastrophic effects that a sleep disorder might have on every aspect of your life. From excessive daytime sleepiness to nocturnal panic attacks, anxiety can make a common sleep disorder that much worse. But, in most cases, what is not so evident is the root cause of your sleep condition.

Sleep apnea is no different. This condition can stem from a wide range of factors - and be worsened by just as many. And that’s also why nearly 80% of sleep apnea cases are undiagnosed or not properly treated!

But if you suffer from anxiety, can this be the cause of your poor sleep quality? The short answer is yes - but there is a little more you need to know. 


What Is Sleep Apnea? Let’s Cover the Basics

Over 70 million Americans today deal with sleep disorders, and around 25 million are affected by sleep apnea, making it the second most common sleep issue after insomnia. This includes 3-7% of men and 2-5% of women in the United States and yet, this condition is not nearly as talked about as insomnia is. 

So, what is sleep apnea - and what are the symptoms of this condition?

Sleep apnea is a sleep disorder that causes repeated stopping and starting of your breathing while you sleep and can have severe consequences. 

Some of the most common types of sleep apnea include:

  • Obstructive Sleep Apnea (OSA) - Often caused by relaxed throat muscles that “obstruct” breathing, this is the most common type of obstructive sleep apnea syndrome.
  • Central Sleep Apnea - This kind of sleep apnea emerges when there is a disruption in the signals the brain sends to the muscles that control breathing.
  • Mixed Sleep Apnea - Also known as complex sleep apnea syndrome, this is a combination of obstructive and central sleep apnea

Some of the most common symptoms of sleep apnea include feeling tired when you wake up, snoring loudly, or waking up with a dry mouth. If left untreated, sleep apnea can trigger or worsen conditions like cardiovascular diseases, heart problems, type 2 diabetes, and daytime fatigue.

After being diagnosed with severe OSA during a sleep study, the most common treatment is to have the patient wear a CPAP machine to get a good night's sleep. This device which provides continuous positive airway pressure helps to ensure that even though there might be obstructions in the airways ... a good flow of oxygen can still make its way to the lungs. This will help reduce sleep deprivation, reduce high blood pressure, and improve normal brain activity that will allow for a deep sleep.


Risk Factors and Causes of Sleep Apnea

As mentioned above, anxiety can worsen sleep apnea. But this isn’t the only trigger. Some risk factors of sleep apnea include:

  • Excess weight and obesity 
  • The circumference of your neck and size of your airway
  • Age and gender (older males are more prone to sleep apnea)
  • Family history and genetics
  • Some medical conditions (like heart disease and Parkinson's disease) and using opioid medications
  • Smoking 

Nasal congestion can also lead to temporary sleep apnea and so it is critical that your sleep specialist also be working with an ENT specialist that has been trained in sleep medicine. Luckily there are many options out there now to help monitor a sleep apnea episode that might happen in the middle of the night and would have previously been missed. When monitoring and observation is combined with sleep apnea treatment it is a win win for everyone.

However, while sleep apnea can be treated with CPAP therapy, anxiety can still cause sleep issues.


Anxiety Disorders and Lack Of Sleep: What You Need To Know

Anxiety is one of the most common mental health disorders and, currently, it is estimated that around 20-25% of the entire American population suffers from it. 

What’s more, studies looking at various mental health conditions have found a robust link between anxiety and sleep disorders, proving that 24-36% of people with insomnia had anxiety. Additionally, around 18% of those with anxiety had nocturnal panic episodes, which can lead to significant sleep disruption. Panic disorder is one of several mood disorders that are caused by anxiety and can be accomonied by various symptoms of anxiety including: chest pain, heart palpitations, shortness of breath, even upset stomach.

If you are looking to get a better night’s sleep, it is important to understand that sleep and anxiety are interconnected - so much so that some sleep disorders are often considered a symptom of anxiety. And, once one of the two is off-balance, you are likely to enter a vicious circle. 

Feelings of fear, anxiety, and worry - a state of mental hyperarousal - can make it harder to fall and stay asleep. In turn, a poor night’s sleep can worsen your daytime anxiety, thus causing distress about falling asleep. Unless addressed, this cycle can continue uninterrupted, taking a drastic toll on your health. 


4+ Effective Ways to Tackle Anxiety Before You Sleep

So, how can you break the vicious circle, fend off anxiety, and get a better night’s sleep? Here are a few treatment options and strategies to try tonight. 

Practice the Right Exercises

Practicing physical exercise before bed can be a great way to reduce the levels of stress hormones in your body, fall asleep faster, and remain asleep for longer. But make sure to choose low- or moderate-intensity activities like a walk, a light jog, or a yoga class. By improving your physical health and making lifestyle changes that will help reduce stressful situations, most people will see an improvement in the severity of OSA as well as sleep problems such as chronic insomnia and anxiety. It is amazing how much benefit can come from simply getting a good night's sleep.

Oppositely, make sure to avoid strenuous activity that can cause your body to release cortisol and adrenaline, while also raising your body temperature. In this state of stress, your body might not be able to switch off right away!

Focus on Your Sleep Hygiene

While you might experience a few good nights of sleep during low-stress periods, if you suffer from anxiety, you should strive for consistent results that will allow you to get the sleep you need even during high-stress times. And, these results aren't built overnight. 

That is why you should focus on establishing a good sleep hygiene routine. Not dissimilarly from looking after your oral health, sleep hygiene refers to a routine that allows you to put your body and mind in the condition to get a better night’s sleep and support your health. 

Some sleep hygiene tips to keep in mind include:

  • Avoid light-emitting screens before bed
  • Avoid activities that add stress to your body like heavy meals and strenuous workouts
  • Abstain from alcohol and caffeine for hours before your bedtime
  • Adjust your natural Circadian Rhythm by seeking exposure to light in the morning and keeping your bedroom dark at night
  • Be consistent with your sleep and wake-up times!

Practice Meditation and Mind-Body Activities To Calm Your Mind Before Bed

If you have been struggling to quiet your mind before bedtime, you are certainly not alone. This is the time when we all tend to mull over stressful thoughts. Luckily, you don’t have to remain a victim of your swirling negative thoughts!

Studies have confirmed that meditative activities - including mindfulness meditations, mind-body scans, and mind-body disciplines like yoga - can help you calm your anxiety before bed. 

Consider introducing diaphragmatic breathing, gentle yoga postures, and relaxation techniques into your routine to stimulate the parasympathetic nervous system and feel immediately more relaxed.

  • Pro tip - If you often feel like your head is too full to concentrate or you are unable to focus on your meditation session, consider investing in a journal. Writing down your anxieties to empty your mind before meditation can help!

Create a Peaceful Sleeping Environment

Your sleeping environment will significantly influence your sleep quality. Whatever you can do to reduce instances of insufficient sleep is going to help you. Some ways that you can help improve your sleep environment include: adjust variables like noise levels, sounds, and temperature to create an environment in which you can be fully comfortable. Ideally, your room should stay at a temperature of around 65F (18C), and be extremely quiet. 

Even more important is to control your light exposure before, during, and after your sleep. At nighttime, your room should be dark to promote the production of melatonin - the sleep hormone. You can do so by investing in shutters and making your room a device-free space. 

As soon as you wake up, seek exposure to natural daylight to feel alert and awake. A great excuse to enjoy your morning coffee on the patio!