Are insomnia and sleep apnea linked to anxiety?

This question was asked in Omaha, Nebraska on 04/05/2012.
I have insomnia, sleep apnea, diabetes, depression, bipolar and other medical issues. I was in Marine Corps boot camp at the age of 17. It was tough. They convinced me I was going to be killed or kill to survive. Every day they would yell and scream, throw trash cans down the aisle, and tip racks over while we were still in bed. Do you think all the stress and anxiety from the Marine Corps boot camp caused me not to sleep? I haven't slept over 3.5 hours in a night since before Marine Corps boot camp.

Doctors Answers (3)

Terry M. Himes, DO
Answered on: 4/23/2012

To answer the first question. 1) Linked only by the fact they are both sleep disorders. Insomnia, can be stress and anxiety driven. 2) With multi-diagnostic related issues, it is difficult to say there is any blame here. Most of the issues you have related are physical issues, which can be caused by interrelated health problems you described. I would suggest your calling an accredited sleep center, and make a consult appointment with a sleep specialist physician. It sounds to complex a set of "physical & mental issues" which could be sleep interrelated.

Syed Nabi, M.D.
Answered on: 4/6/2012 2

Absolutely. Sleep apnea, in fact any sleep disorder, is very closely related to anxiety and mood disorder. If you think about it, if you are not getting a good quality sleep, your brain is not resting, and it will reduce the threshold to handle the daily grind we all go through. When you are a soldier, it just compounds everything: lack of sleep, high levels of stress, pressure, etc. all affect sleep and our capacity to handle stress and increased work loads. The treatment plan in such cases is to not only improving quality of sleep (by fixing sleep apnea, insomnia, etc.) but also addressing the concurrent mood disorders including anxiety, depression, PTSD, etc. and any other medical problem.

Yes. Anxiety can interrupt sleep leading to insomnia. Anxiety is associated with increased levels of dopamine and adrenalin which override the neurotransmitters designed to promote sleep. When one stops breathing while asleep (sleep apnea) the only way to avoid dying is to start breathing again. The only way to survive is for the tongue and soft palate which have obstructed the upper airway to return to their normal positions. In order for this to happen, the brain must arouse. This is not an awakening but there is a brain arousal as measured by the electroencephalogram which appears for a few seconds that you are awake. When the arousal occurs there is a surge of adrenalin which elevates the blood pressure, the heart rate, the blood sugar and cortisol levels. If there is a true awakening at this time one would describe this as an anxiety attack.