Anxious? Depressed? Sleep Apnea May Be the Cause

Most people will recognize the effects of a poor night’s sleep, feeling groggy the next day, struggling to concentrate and being a little more irritable than usual. 

However, if you have a sleep disorder like obstructive sleep apnea, there are many back-to-back nights of interrupted sleep, compounding the problems. 

Excessive fatigue from a sleep disorder has an impact on your professional and personal life as you struggle to function normally. 

Studies also point to an increase in the risk of anxiety and depression if you experience excessive daytime sleepiness, particularly if as a result of sleep apnea. 

Explaining the Link

Obstructive sleep apnea is the most common form of sleep apnea and can result in frequent interruptions to sleep due to breathing difficulties. This is caused by a collapse of the upper airways, resulting in a drop in oxygen levels and an increase in carbon dioxide levels in the blood.

The brain picks up on this imbalance as the blood becomes acidic, and prompts the body to awake for air. Sometimes you may awake gasping for air. 

Depending on the sleep apnea’s severity, these interruptions to sleep can happen hundreds of times a night. You may not even realize it is happening, with a partner the first to notice the breathing issues -- as loud snoring is quite often the primary symptom of sleep apnea.

The large majority of sleep apnea cases go undiagnosed, and therefore this disruptive sleep pattern continues indefinitely. With the neurotransmitters working overtime during the night to alert your body for air, they will become depleted for the following day, resulting in a lack of energy and excessive daytime fatigue.

This lack of energy -- and a constant feeling of fatigue -- may increase the risk from anxiety and depression as you lose motivation and energy to perform activities which could help boost your mental health.

Studies in the Link to Sleep Apnea

Obstructive sleep apnea is a debilitating sleep disorder which left untreated can increase the risk of health issues such as heart disease, stroke and type 2 diabetes. Studies also point to a connection between this sleep disorder and anxiety and depression.

According to a 2014 study in the Journal of Research in Medical Sciences, 53.9% of adults with obstructive sleep apnea reported some degree of anxiety, with 46.1% experiencing some degree of depression. In 2019, a report by the Journal of Psychiatric Research reported that 14% of suicidal adults who had a major depressive disorder were diagnosed with obstructive sleep apnea.

Symptoms of sleep apnea have also been linked to a higher risk of mental health issues. Snoring and breathing difficulties are two of the prime symptoms of obstructive sleep apnea, and a 2012 report indicated both these symptoms are associated with a greater risk from depression.

Treatments to Improve Sleep

Treating the symptoms of sleep apnea may therefore improve your mood and help address mental health issues. 

Someone who is suffering with excessive fatigue -- while also reporting depressive moods -- will likely be referred for a sleep test. This will help diagnose the presence of sleep apnea, a treatable disorder where the symptoms can be managed.

CPAP is one of the primary methods to treat sleep apnea, using a device to supply pressurized air through a mask worn overnight to prevent the airways from collapsing. By keeping the airways open, you prevent the breathing difficulties and the arousal of the body prompted by the brain.

There can be an issue for some people in wearing a mask overnight as it can feel claustrophobic and may even make someone’s anxiety worse. In these instances, you should work with your health care provider to find a more suitable mask, one which covers less of the face. 

An oral device worn at night, similar to a dental retainer, may also be recommended to help keep the airways clear.

Positional therapy is another option. The symptoms of sleep apnea may be worse for someone who sleeps on their back, with the gravitational pull on the throat tissue contributing to the collapse of the upper airways and the lack of oxygen reaching the brain. By sleeping on their side some people can find their breathing normalizes. You could wear a device around the waist and back to help ensure you sleep on your side.

However, there is evidence suggesting that CPAP can help improve someone’s mood. A 2019 study in EclinicalMedicine reported finding CPAP reduced the chances of depression by as much as 20% for those with moderate to severe obstructive sleep apnea and cardiovascular disease.

While there is evidence that treating sleep apnea can help improve mental health, if this is not proving the case for some people, they may be referred to a psychiatrist for further professional help.

Lifestyle Changes

There are a number of lifestyle changes that may be recommended to help combat the symptoms of sleep apnea. By making some adjustments to your routine you may also sleep better, while also reducing stress and anxiety levels. These include:

  • Exercise – excess weight is a major contributing factor for obstructive sleep apnea. As well as helping you lose weight, exercise can also help you sleep better as well as release mood-enhancing endorphins.
  • Relaxation – meditate, read or have a hot bath to help relax before bed.
  • Sunlight – make sure you head outside for some natural light every day.
  • Reduce alcohol and caffeine consumption – avoiding completely in the hours before bed.
  • Bedtime routine – go to bed and get up the same time each day.
  • Bedroom environment – encourage sleep by removing screens from the bedroom and having a cool, quiet and dark room in which to sleep.

Making some simple adjustments to your daily routine can help ease your sleep apnea, resulting in more hours of sleep and less daytime fatigue. At the same time, you could also be reducing your stress levels and boosting your mental health.