Sleep Apnea: Managing Anxiety and Breathing Issues

Q: Sleep Apnea: Managing Anxiety and Breathing Issues

Hello, netizen： This is likely caused by anxiety rather than sleep apnea. <br>If someone has a more sensitive personality, their reaction to the stress of the pandemic may be more intense. <br>The invisibility and harmfulness of the virus, along with the uncertainty of transmissi

Sleep apnea?

Hello doctor, I have anxiety disorder and often search for information on Google, which ends up scaring me.
Whenever I feel unwell, I want to see a doctor for reassurance.
However, due to the recent outbreak of the pandemic and seeing news about sudden deaths from hypoxia, I have fallen back into panic.
Last night, I finally managed to fall asleep, but I woke up suddenly due to a breath cessation (the last time this happened was last year).
After waking up, my heart was racing, and I was sweating a little.
Negative thoughts flooded in, making it hard to distinguish whether I was experiencing the hypoxia mentioned in the news or a panic attack.
I also feared that my breathing would stop again as I was gradually falling asleep, which made me even more afraid to sleep, leading to insomnia until morning.
I only slept for a little over three hours before waking up, and I still felt shaken afterward.
I am very worried that the same issue will occur again tonight.
I would like to seek your professional advice, thank you, doctor, for your hard work.

nana, 20~29 year old female. Ask Date: 2021/06/06

Dr. Wu Enliang reply Psychiatry

Hello, netizen: This is likely caused by anxiety rather than sleep apnea.
If someone has a more sensitive personality, their reaction to the stress of the pandemic may be more intense.
The invisibility and harmfulness of the virus, along with the uncertainty of transmission, can undermine our sense of safety and make us feel uneasy.
Gathering information and taking self-protective measures can enhance our physical and mental sense of security; however, excessive information and actions can also lead to increased stress.
Therefore, the information and recommendations provided by the government should serve as the best guidance amidst information overload.
For instance, joining the "Disease Control Buddy" on LINE, watching the daily press conferences in the afternoon, or downloading the "Taiwan Social Distancing App" from the Central Epidemic Command Center can help implement adequate self-protection while minimizing exposure to pandemic-related information.
It is advisable to limit the time spent on official pandemic-related news to no more than thirty minutes a day and to refrain from watching reports from other news media, as they often repeat information and highlight many uncontrolled pandemic situations abroad or magnify domestic infection events, which can lead to psychological stress and panic.
Additionally, it is important to learn to assess the authenticity of information and not to believe in false news circulated on social media, as this can negatively impact one's emotions.
If emotional distress persists for too long or affects daily functioning, it is necessary to seek professional assistance to change adverse physical and mental responses.
Dr.
Wu En-liang

Reply Date: 2021/06/06

More Info

Understanding sleep apnea and its relationship with anxiety can be quite complex, especially for individuals who are already predisposed to anxiety disorders. Your concerns about sleep disturbances, particularly the episodes of breathing cessation during sleep, are valid and warrant attention. Let's delve into the interplay between anxiety, sleep apnea, and effective management strategies.

Understanding Sleep Apnea
Sleep apnea is a serious sleep disorder characterized by repeated interruptions in breathing during sleep. The most common type is obstructive sleep apnea (OSA), where the throat muscles intermittently relax and block the airway during sleep. This can lead to fragmented sleep and reduced oxygen levels in the blood, which can cause a range of symptoms, including excessive daytime sleepiness, irritability, and difficulty concentrating.

The Connection Between Anxiety and Sleep Apnea
Anxiety can exacerbate the symptoms of sleep apnea. Individuals with anxiety disorders may experience heightened sensitivity to bodily sensations, leading to increased awareness of breathing patterns during sleep. This hyperawareness can trigger panic attacks, especially if they perceive any difficulty in breathing as a sign of a more serious issue, such as "happy hypoxia" or sudden cardiac events.
Your experience of waking up suddenly due to breathing cessation, accompanied by a rapid heartbeat and cold sweat, is indicative of a panic response. This can create a vicious cycle where anxiety about sleep leads to poor sleep quality, which in turn exacerbates anxiety.

Strategies for Managing Anxiety and Sleep Apnea
1. Consult a Sleep Specialist: Given your history of sleep apnea, it is crucial to consult with a sleep specialist. They may recommend a sleep study (polysomnography) to assess the severity of your condition and determine the best treatment options, which may include Continuous Positive Airway Pressure (CPAP) therapy.

2. Cognitive Behavioral Therapy for Insomnia (CBT-I): This therapeutic approach can help address the anxiety surrounding sleep. CBT-I focuses on changing unhelpful thoughts and behaviors related to sleep, teaching relaxation techniques, and establishing a healthy sleep routine.

3. Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as meditation or deep-breathing exercises, can help reduce anxiety levels. These techniques can also be beneficial before bedtime to promote relaxation and prepare your body for sleep.

4. Sleep Hygiene: Establishing good sleep hygiene is essential. This includes:
- Keeping a consistent sleep schedule (going to bed and waking up at the same time every day).

- Creating a comfortable sleep environment (dark, quiet, and cool).

- Avoiding stimulants like caffeine and nicotine close to bedtime.

- Limiting screen time before bed to reduce exposure to blue light.

5. Medication Management: Since you are already taking medication for anxiety, it’s important to discuss any changes or concerns with your prescribing physician. They may consider adjusting your medication or adding a sleep aid if necessary.

6. Education and Awareness: Understanding your condition can help alleviate some of the fear associated with it. Educate yourself about sleep apnea and its management, and try to separate fact from fear.
7. Support Systems: Engaging with support groups or therapy can provide a safe space to express your fears and learn from others who have similar experiences.

Conclusion
Navigating the challenges of anxiety and sleep apnea requires a multifaceted approach. By addressing both the psychological and physiological aspects of your condition, you can work towards improving your sleep quality and reducing anxiety. Remember, it’s essential to communicate openly with your healthcare providers about your symptoms and concerns. With the right support and strategies, you can regain control over your sleep and overall well-being.

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