Can Insomnia Cause Sleep Apnea?

Insomnia is a disorder that causes difficulty in falling asleep or staying asleep. You can also find yourself frequently waking up too early. It is a debilitating disorder that can affect both your working and personal life.

Evidence also points to insomnia increasing your risk of another sleep disorder: obstructive sleep apnea. So, can insomnia cause sleep apnea? While the two disorders are different, research suggests a link between them.

Can Insomnia Cause Sleep Apnea?

Obstructive sleep apnea, the more common form of the disorder, is characterized by breathing pauses resulting from blocked or partially blocked airways. This results in sleep disruption as the brain responds to the fall in oxygen levels by prompting the body to wake for air. This can happen hundreds of times within a single night.

Does that mean insomnia can cause sleep apnea? While insomnia is not a direct cause, it can be a contributing risk factor. This link can mean that someone with insomnia is at a higher risk of developing obstructive sleep apnea. Indeed, a person with either insomnia or sleep apnea  is 50 to 60% more likely to develop the other disorder.

Even if insomnia might not directly cause sleep apnea, it can worsen the symptoms. Reasons for this include:

  • Insomnia results in sleep deprivation that reduces oxygen levels.
  • Frequent nights of disrupted sleep from insomnia may predispose someone to more obstructive sleep apnea events.
  • Insomnia-related sleep deprivation could reduce muscle tone in the airways.
  • Insomnia can result in light sleep and make someone more prone to waking during the breathing pauses associated with sleep apnea.

Unless treated, both insomnia and sleep apnea can increase the risk of serious health issues  related to sleep deprivation and falling oxygen levels. 

However, as having one disorder can significantly increase the risk of developing the other, such health risks are compounded when they co-occur. 

Can You Have Insomnia and Sleep Apnea Together?

When considering if insomnia can cause sleep apnea, another question arises:  can you have insomnia and sleep apnea together? It is possible and even likely that these conditions occur together. It is termed co-morbid insomnia and sleep apnea (COMISA) when one individual experiences both disorders.

When these conditions co-occur, there is a further increased risk of developing serious health issues like heart disease and high blood pressure. In fact, you are at a 50% higher risk of death compared to someone with just one disorder or someone without a sleep disorder.

In one study conducted over 15 years, researchers found that COMISA sees you at 70% higher risk of cardiovascular disease and twice as likely to have high blood pressure compared to someone without either insomnia or sleep apnea.

The question of whether or not insomnia can cause sleep apnea becomes a critical one in lieu of these statistics. However, it can be difficult to determine whether these disorders co-occur as they share several symptoms, including:

  • Daytime fatigue
  • Difficulty falling asleep or staying asleep
  • Problems waking
  • Issues with attention and concentration
  • Problems with memory 
  • Mood swings

As well as the potential for long-term health issues, COMISA places you at increased risk of accidents at work and traffic accidents from fatigue due to poor quality sleep.

Just as insomnia can worsen obstructive sleep apnea symptoms, sleep apnea can worsen your insomnia. Someone with severe obstructive sleep apnea can briefly wake for air over 30 times every hour. This frequent disruption to sleep will unsurprisingly exacerbate symptoms of insomnia.

Diagnosis

While treating both disorders is essential, the similarity in symptoms can make diagnosis difficult. Each disorder needs to be diagnosed separately before a diagnosis of COMISA is possible.

If you have previously been diagnosed with insomnia you may then be wondering whether insomnia can cause sleep apnea. You may display additional sleep apnea symptoms like morning headaches and a dry mouth.

If your healthcare provider suspects obstructive sleep apnea they will recommend a sleep study called polysomnography. This involves either a home sleep test or an overnight stay at a sleep clinic where you are monitored during sleep. The data recorded from this study determines whether you have sleep apnea and the severity of the disorder, which is important for determining the appropriate treatment.

Treating COMISA

The co-existence of two sleep disorders can provide challenges. You need to treat each disorder separately, but treating one can affect the other.

Prescription or over-the-counter sleeping aids are commonly used to treat insomnia. In recent times, cognitive behavioral therapy has been recommended by more healthcare professionals. This type of therapy helps people change their thought processes to better deal with their problems with sleep.

CPAP, BiPAP and APAP are primary treatments for moderate to severe obstructive sleep apnea. However, some people find it difficult to tolerate the pressurized air required to keep the airways free of obstruction. The air is delivered through a mask, which can also be difficult to adjust to for some people, particularly those who experience feelings of claustrophobia.

Some evidence suggests if you have insomnia you may be more likely to struggle to adapt to PAP therapy. Therefore, it may be recommended to begin the treatment of COMISA by focusing on your insomnia first before starting the treatment plan for obstructive sleep apnea. However, if sleep apnea is worsening your insomnia, treating sleep apnea with PAP therapy could also help your insomnia.

Tips to Improve Sleep

Alongside treating a sleep disorder, you can take steps to improve your sleep.

  • Go to bed and wake up at the same time every day to create a sleep schedule for your body.
  • Create a dark and quiet bedroom environment that encourages sleep.
  • Avoid large meals, caffeine, and alcohol late in the evening.
  • Find ways to relax before bed, for example, meditation or reading.
  • Exercise  during the day, although not too close to bedtime

While insomnia might not be a direct cause of obstructive sleep apnea, it can be a contributing risk factor and can worsen sleep apnea symptoms. If you have insomnia it is important to test for obstructive sleep apnea as COMISA, the co-occurrence of insomnia and sleep apnea, increases your risk of cardiovascular disease and high blood pressure.