Sleep Disturbances: Anxiety, Nightmares, and Breathing Issues

Sleep issues

Hello Doctor, I often have nightmares during sleep, and whenever I do, my heart races significantly.
However, I'm not sure if this is related to the nightmares.
I consulted a cardiologist, and after examination, the doctor said my heart is normal and referred me to a psychiatrist.
The psychiatrist later diagnosed me with anxiety disorder.
After taking medication for a year, my condition stabilized, but earlier this year, I started experiencing episodes of waking up gasping for air while sleeping, occurring about every two weeks.
I also underwent a sleep study, but there were no signs of sleep apnea.
These experiences have made me very anxious about various health conditions, and I even start to believe that my loved ones might have some illnesses, which increases my anxiety.
Therefore, I have a few questions I would like to clarify with you: 1.
If I wake up feeling like I can't breathe in the middle of the night, and it is not sleep apnea, could it be caused by other mental health disorders? 2.
What are some ways to address the issues mentioned above or to reduce this anxiety? Thank you, Doctor.

Xiao Bang, 20~29 year old female. Ask Date: 2023/08/09

Dr. Li Guanying reply Psychiatry

Dear Sir/Madam,
From your letter, it is clear that you are experiencing discomfort and distress due to your sleep issues.

1.
Facing an uncertain future, depression is a common condition in modern society.
It is a chronic illness that requires long-term treatment for recovery.

2.
If you are experiencing sleep apnea or insomnia, you may consider undergoing a polysomnography (PSG) to assess your sleep functions.
Our clinic offers outpatient services from Monday to Friday, both in the morning and afternoon, and we can assist you with this.
If necessary, we can also refer you for a PSG.
I recommend that you visit our clinic for a personal evaluation of your symptoms, so we can collaboratively discuss the best course of action for you.
Wishing you good mental and physical health.

Reply Date: 2023/08/09

More Info

Dear Patient,
Thank you for sharing your concerns regarding your sleep disturbances, particularly the nightmares, anxiety, and episodes of feeling unable to breathe during sleep. It’s understandable that these experiences can lead to increased anxiety and worry about your health and the health of your loved ones. Let’s address your questions and provide some insights into your situation.

1. Feeling Unable to Breathe During Sleep: The sensation of waking up gasping for air can indeed be alarming. While sleep apnea is a common cause of such symptoms, as you mentioned, your sleep study did not indicate any breathing interruptions. Other potential causes could include anxiety or panic attacks that manifest during sleep. Anxiety can lead to hyperventilation or a feeling of tightness in the chest, which may be perceived as difficulty breathing. Additionally, conditions such as nocturnal panic attacks can occur, where individuals wake up suddenly feeling intense fear and physical symptoms, including a racing heart and difficulty breathing. It’s essential to consider the psychological aspect of your symptoms, especially since you have a history of anxiety.

2. Managing Anxiety and Sleep Disturbances: Addressing your anxiety is crucial for improving your sleep quality. Here are several strategies that may help:
- Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for anxiety and sleep disturbances. CBT can help you identify and challenge negative thought patterns that contribute to your anxiety, particularly those related to your health and sleep.

- Relaxation Techniques: Incorporating relaxation exercises into your bedtime routine can help calm your mind and body. Techniques such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation can be beneficial.

- Sleep Hygiene: Establishing a consistent sleep schedule and creating a restful sleep environment can significantly improve your sleep quality. Avoid stimulants like caffeine and nicotine close to bedtime, and limit screen time before sleep. Ensure your bedroom is dark, quiet, and at a comfortable temperature.

- Physical Activity: Regular physical activity can help reduce anxiety and improve sleep quality. Aim for at least 30 minutes of moderate exercise most days, but try to avoid vigorous exercise close to bedtime.

- Medication Review: Since you have been on medication for anxiety, it’s worth discussing with your psychiatrist whether your current treatment plan is optimal. Sometimes, adjustments in medication or dosage can lead to improvements in both anxiety and sleep.

- Support Groups or Therapy: Engaging in therapy or support groups can provide you with additional coping strategies and a sense of community, which can be comforting when dealing with anxiety.

It’s important to continue working closely with your healthcare providers, including your psychiatrist, to monitor your symptoms and adjust your treatment plan as necessary. If your symptoms persist or worsen, do not hesitate to seek further evaluation or support.

In conclusion, while your experiences are understandably distressing, there are effective strategies and treatments available to help manage your anxiety and improve your sleep. Remember, you are not alone in this, and with the right support, you can find relief and regain control over your sleep and well-being.

Wishing you restful nights and peace of mind.

Best regards.

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