Anxiety and sleep apnea: The sleep/health connection

Anxiety and sleep apnea are like fish and water: Find one, and you’ll usually find the other, too.

This connection is supported by more and more studies as the years pass. For example, in December 2012, a major European medical journal published a study ¹ finding that more than half of patients diagnosed with sleep disorders “had some degrees of depression and anxiety.”

The study noted that sleep apnea was not associated with the severity of anxiety, only the presence of it. But other sources have made the connection between sleep apnea and anxiety at its most severe levels — namely, post-traumatic stress disorder (PTSD). According to The New York Times Health Guide, sleep apnea may “intensify symptoms of PTSD, including sleeplessness and nightmares.” The guide notes that sleep apnea is also sometimes associated “with a risk for panic disorder.” ²

A 2005 study by the journal SLEEP ³ helps clarify the anxiety and sleep apnea connection. Compared with patients not yet diagnosed with sleep apnea, those who were diagnosed experienced a “significantly greater prevalence” for “mood disorders, anxiety, posttraumatic stress disorder, psychosis, and dementia in patients with sleep apnea,” the study found.

Still, it’s important to note that, while anxiety and sleep apnea are often found together, one doesn’t necessarily cause the other. “It’s been hard to tease out whether sleep loss is simply a byproduct of anxiety, or whether sleep disruption causes anxiety,” University of California, Berkeley doctoral student Andrea Goldstein said in a newly published study on anxiety and sleep deprivation. ⁴

Often, a third factor — such as stress or uncertainty — is believed to be the cause of both anxiety and sleep apnea. In a newsletter also published by UC Berkeley, ⁵ an urgent-care physician notes that a variety of conditions in the student population ranging from “oversleeping to sleep-inhibiting anxiety disorders and physical issues like sleep apnea,” suggest that the stress of student life may lead to both anxiety and physical sleep disorders such as OSA — although one doesn’t necessarily cause the other.

But even a basic correlation between anxiety and sleep apnea is enough to intrigue researchers, who hope that treating one condition may lead to the resolution of both. For example, the goal of the new UC Berkeley study was to determine the connection between lack of sleep to the ramping up of brain activity that’s believed to contribute to anxiety and “excessive worrying.” The study concluded that sleep deprivation’s effects on the brain increase “anticipatory anxiety.”

“These findings help us realize that those people who are anxious by nature are the same people who will suffer the greatest harm from sleep deprivation,” said professor of psychology and neuroscience Matthew Walker, the paper’s senior author. “By restoring good quality sleep in people suffering from anxiety, we may be able to help ameliorate their excessive worry.”

What’s that mean? Many of the best practices for healthy sleep directed at those who suffer from mild to moderate sleep apnea could also be effective in stymying the impulse to worry and experience undue anxiety — yet another incentive to seek out healthy sleep solutions if you’re experiencing any form of insomnia or sleep deprivation.