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Once we learn about chronic health conditions, it’s easy to fall down a rabbit hole. One such condition is obstructive sleep apnea (OSA). The condition is chronic since it occurs every time you sleep and can only be managed through therapy. The condition rarely goes away by itself.
During sleep, what appears to be a mechanical problem with breathing turns out to be much more complex in its effects on the rest of our bodies. You may not know, for example, that OSA, if left untreated, is associated with a wide array of chronic health conditions. People with OSA may develop a hidden case of high blood pressure. Similarly, untreated OSA can cause Type 2 diabetes.
Could OSA contribute to mental health problems as well? Sadly, the answer is yes.
Psychological effects of obstructive sleep apnea
For many years, research has been conducted to identify associations between OSA and mental health issues. According to recent studies, there is a clear link between OSA and mood disorders like depression.
In fact, OSA contributes to several mental health concerns besides major depression disorder (MDD), such as generalized anxiety disorder (GAD), schizophrenia, bipolar disorder, post-traumatic stress disorder, substance abuse, and panic attacks.
Sleep apnea, and depression
There are often similarities in the symptoms experienced by people with MDD and OSA, such as:
- Fatigue during the day
- Concentration issues
- excessive irritability
- Gaining weight
Someone who complains of mental health issues such as depression may, after going through an OSA screening, discover that they also suffer from sleep apnea.
The VA conducted a large study that found people with MDD have a five-times greater chance of having OSA, with more than half of the OSA patients in their study meeting the criteria for MDD. It can also be the case with chronic insomnia, which is also well known to overlap with major depressive disorder (MDD).
Low serotonin levels appear to link both conditions, although in different ways. In the brain, serotonin is responsible for regulating mood, so low levels mean negative emotions. Serotonin also plays a role in the nerve function of the upper airway during sleep. Inadequate supply could play a role in the complex set of conditions leading to OSA.
Researchers from the VA study found that, despite controlling for obesity as a risk factor, OSA was associated with both mood disorders and anxiety disorders.
Sleep apnea, and anxiety
A person with OSA is nearly twice as likely to suffer from a generalized anxiety disorder. According to one study, the more severe the case of OSA, the higher the chance of anxiety symptoms. In fact, over two-thirds of people who dealt with anxiety also suffered from severe OSA.
Sleep apnea and mental health problems
Is there a way to move forward when an individual is diagnosed with OSA and depression or anxiety?
As a general rule, it is best to treat OSA as the primary condition, as it may contribute to depression and anxiety. There is a good chance that depressive or anxious symptoms will subside or even disappear once they are treated.
Additionally, certain antidepressant and anti-anxiety medications (such as benzodiazepines and other sedatives or hypnotics) can actually worsen an existing case of OSA. This might explain why your doctor may suggest at least starting with positive airway pressure (PAP) therapy (such as CPAP) before treating the mental health symptoms. According to research, CPAP use can reduce anxiety and depression severity, especially for women.
Make sure you don’t go at it alone.
It can be difficult to know when having one mental or physical health issue will lead to another, but this does happen. Unfortunately, chronic illness is like that. It is possible for one health issue to lead to another over time.
A person with OSA may suffer from problematic sleep caused by ongoing stress unrelated to their condition. A pandemic is an example of stress-induced insomnia and disturbed sleep affecting millions in 2020.
If you’re unsure about the source of your sleep problems, don’t guess why or ignore the symptoms. Consider consulting with your physician and a sleep apnea specialist. With their assistance, you can determine whether you have any mental or physical health concerns that need to be addressed. Our sleep apnea center in Glen Burnie, MD specializes in treating sleep apnea patients. To schedule an appointment, call our sleep apnea dentist in Glen Burnie today. Ultimately, figuring out the problem and treating it, as well as getting more sleep, are your top priorities.
