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What causes sleepiness all the time? Is it Sleep apnea or Anxiety?

Are you snoozing during an office presentation? Or nodding off on the chair? Do you have heavy eyelids during mid-afternoon? Do you need coffee to resume your performance at work? What causes sleepiness all the time? You may not realize it but you are sleep deprived.

Do you feel groggy at day, loud snoring and gasping at night? Insomniac!

Get a word, where the problem is!

Let us first understand these two medical terms “sleep apnea and anxiety” individually.

What is Sleep apnea?

Sleep apnea is one type of serious sleep disorder that is characterized by brief interruptions of breathing during sleep. This interruption period lasts 10 seconds or more and may occur repeatedly throughout the night.

Ever felt as being chocked or strangled at late hours!

Have a read on these common symptoms of sleep apnea. 

Common symptoms of sleep apnea are:

  • Restless sleep or insomnia
  • Excessive fatigue and sleepiness during daytime
  • Sudden awakening with feeling shortness of breath
  • Loud snoring (followed by gasping)
  • Dry mouth or sore throat upon awakening
  • Morning headaches
  • Attention problems, irritability, forgetfulness
  • Mood or behavior changes, anxiety, and depression

Types of sleep apnea:

There are two types of sleep apnea:

Obstructive sleep apnea:

This type of apnea is more common and is characterized by repeated upper airway obstruction during sleep. The soft tissue in the back of the throat relaxes during sleep and blocks the airway, often causing a person to snore loudly.

Central sleep apnea:

This form of apnea is less common and involves the central nervous system, occurring when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore.

What is Anxiety?

The term anxiety as “an emotional behavior, characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure, may also cause insomnia in many people” (American Psychological Association)

Anxiety is the body’s response to stress. It is a combination of physical, mental and emotional factors that may together make a person feel anxious.

Now, the question is how this body and mind disease co-exist!

How sleep apnea and anxiety in a patient are co-related?

Sleep apnea is a medical disorder that has significant health and behavioral effects. It is of particular interest to psychiatrists because it mimics or exacerbates symptoms of psychiatric disturbances such as depression, anxiety, and panic disorder.

Sleep apnea if left untreated can pose other serious health problems, such as:

  • High blood pressure
  • Stroke
  • Heart failure, irregular heartbeats, and heart attacks
  • Diabetes
  • Depression

How sleep apnea can cause anxiety?

Obstructive sleep apnea is a condition in which a person wakes frequently and very briefly throughout the night due to sudden breathing interruption.  During this breathing cessation episode, the brain receives an alarming signal, which stimulates the body to initiate the breathing process again. This activity may be repeated and the person awakes frequently throughout the night. The patients may complain about sleep disruption, headache, mood disturbance, irritability, anxiety and memory impairment.

These periodic apnea episodes interfere with sleep and make it more difficult for the brain to cope with stress. Because sleep is discontinued, again and again, sleep apnea can alter the neurochemicals responsible for a person’s thinking pattern and mood and eventually the brain’s activity. 

Related: What can cause anxiety in adults?

How anxiety can cause sleep apnea?

Another approach is that anxiety and stress can affect your nervous system, causing your brain to initiate a response to take short, shallow breaths. This can lead to carbon dioxide (CO2) retention in brain cells which in turn can affect other areas in the brain that triggers fear and panic attacks.

So, if someone is persistently oxygen-deprived from not breathing at night due to sleep apnea, the area of the brain that processes fear and behavior may be stimulated causing agitation and anxiety due to restless sleep.

Therefore, there is a complex yet coherent relationship between sleep and mood, because disrupted night sleep as a result of sleep apnea can lead to emotional changes, clinical depression or anxiety (as well as other psychiatric conditions) while in turn, these conditions can also compound or further disrupt sleep.

It is a two-way connection!

Related: How to stop anxiety attacks at night?

Research findings of sleep apnea and anxiety:

  • One of the large scale research studies revealed the fact, that nearly 19,000 people with depression were 5 times more likely to suffer from obstructive sleep apnea or other forms of sleep-breathing disorders.
  • A study performed in Iran showed that the frequency of anxiety in obstructive sleep apnea patients is higher than in the general population regardless of gender.

Does anxiety aggravate sleep apnea?

It’s now clear that apnea can cause anxiety and panic attacks, and anxiety can lead to sleep apnea. In fact, anxiety can prevent you from having a sound sleep at night which can eventually provoke sleep apnea. It can thus, negatively affect your treatment for sleep apnea. Apnea not only causes anxiety, but it can also trigger anxiety in those who already have a history of anxiety or panic disorders.

So, If you feeling too snoozy in the day and too restless at night, snoring loud when you sleep, visit your doctor to have a complete physical and mental health picture and to arrest the crook timely- Is it sleep apnea or anxiety?

Dr. Tayaba Sarfraz

Medical Doctor | Medical Educationist & Writer Mommy of 2 | Master chef | Health Enthusiast

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