Recently, research has shown a high rate of comorbidity between sleep apnea and anxiety disorders. The occurrence of obstructive sleep apnea is found to coincide with anxiety disorders all along the spectrum but has been reported in highest numbers with those who suffer from posttraumatic stress disorder (PTSD). Studies suggest that sleep apnea can contribute to certain symptoms of anxiety disorders and that treatment of sleep apnea can help bring relief, especially to those with PTSD.
It is hypothesized that sleep apnea may predate many anxiety disorders and may play a contributing role in the development of the anxiety disorder. The REM cycle of sleep is thought to be the phase of sleep when a lot of emotion filled stimuli is processed and the constant interruption of sleep patterns brought on by sleep apnea hinder this system. In cases where a severe trauma has occurred, the REM cycle interruptions could play a role in the dysregulation of the limbic system, a system which moderates the fight or flight responses of the body and is central to the development of PTSD.
A new study has revealed that treating sleep apnea can help to reduce some symptoms of PTSD, specifically nightmares and sleep difficulties characteristic of the disorder. Treatment for sleep apnea involves the use of a continuous positive airway pressure (CPAP) machine. The machine works by using a face mask and hose which prevents the airways from being obstructed during inhalation by increasing the air pressure on the throat.
By treating the major symptoms of sleep apnea, sleep cycles disturbances are not able to affect those with PTSD and other anxiety disorders as profoundly.
One problem that prevents the treatment from being successful is that people who start using the CPAP machine often find it to be very uncomfortable at first. Side effects include sinus and throat irritation and nightmares or unusual amounts of dreaming. These effects commonly subside after an adjustment period.
Their initial presence means that compliance with sleep apnea treatment is often difficult for individuals with PTSD. Many find the mask causes feelings of claustrophobia which can be very activating to the fight or flight reactions in the limbic system. In spite of a decrease in sleep apnea symptoms, there is a delay in the limbic system returning to equilibrium, and the treatment is often abandoned before the benefits can be felt by the individual.
To offset the high rate of noncompliance, multiple options for masks are being made available along with cognitive and behavioral support to help offset the discomfort. Compliance rates increase greatly once the reduction in nightmares is evident to the person dealing with PTSD, and in studies this rate has reached as high as 60 percent.
With the increased compliance comes increased relief from nightmares that often plague many with PTSD. One patient to benefit from the treatment reported that the occurrence of nightmares decreased from every night to only a couple a month. He claimed he was able to avoid more dangerous methods of achieving sleep, such as combinations of sleeping and pain pills.
The discovery of the relationship between sleep apnea and anxiety disorders has led to another form of treatment that may help those suffering with the symptoms of PTSD. This is no small discovery and no small victory for the many people who struggle with the debilitating effects of nightmares and sleep difficulties brought on by the disorders.
Written by: Vanessa Blanchard