Can Sleep Apnea Be Caused By PTSD?

Yes, research suggests PTSD can disrupt breathing patterns causing sleep apnea.

Does post-traumatic stress disorder (PTSD) cause sleep apnea? As we continue to learn more about PTSD, researchers are discovering its potential impact on various aspects of one’s health, primarily their sleep.

Sleep apnea affects millions around the world. It is a sleep disorder where an individual’s breathing repeatedly stops and starts while they’re asleep. Research has shown that people who have PTSD may be at a greater risk of developing sleep apnea. So, if you or someone you know suffers from both conditions, there may be a connection between them worth exploring.

In this article, we delve into the research surrounding PTSD and its potential correlation with sleep apnea. We will explore what PTSD is and how it affects sleep patterns that lead to the development of sleep disorders such as sleep apnea. Read on to find out whether there is a link between these two conditions and what strategies could be used for treating them effectively.

Can sleep apnea be caused by PTSD?

Research shows that PTSD may increase the risk of developing sleep apnea. PTSD is a mental health condition that occurs after experiencing or witnessing a traumatic event. The condition can cause nightmares, flashbacks, anxiety, and depression, which can lead to disrupted sleep patterns.

Sleep apnea is often caused by an obstruction in the airway during sleep. However, some studies suggest that PTSD may also contribute to the development of sleep apnea. One study found that individuals with PTSD were more likely to have symptoms of sleep apnea, such as snoring and pauses in breathing during sleep. The researchers suggested that this could be due to the physiological changes that occur in the body during a traumatic event, such as an increase in heart rate and blood pressure, which can affect breathing patterns.

Another study found that individuals with PTSD had higher levels of cortisol, a stress hormone, which has been linked to an increased risk of sleep apnea. Additionally, individuals with PTSD may be more likely to engage in behaviors that contribute to sleep apnea, such as smoking or alcohol consumption.

Overall, while more research is needed to fully understand the relationship between PTSD and sleep apnea, current evidence suggests that there is indeed a link between the two conditions.

How PTSD aggravates sleep apnea?

PTSD can aggravate sleep apnea in different ways.

  • Hyperarousal – people with PTSD often have hyperarousal. This can lead to increased muscle tension in the upper airway and obstructive breathing during sleep. This results in snoring or pauses in breathing, which are hallmark symptoms of sleep apnea.
  • Insomnia – PTSD can cause nightmares and flashbacks that disrupt sleep and increase the likelihood of developing insomnia. Insomnia is a common comorbidity of both PTSD and sleep apnea, and it can exacerbate the symptoms of each condition.
  • Overactive sympathetic nervous system – PTSD sufferers also have this which can lead to an increase in heart rate and blood pressure during sleep. These physiological changes can contribute to disrupted breathing patterns and increase the risk of developing sleep apnea.
  • Unhealthy behaviors – as mentioned above, smoking, alcohol consumption, and also weight gain are common in individuals with PTSD. These behaviors can also exacerbate the symptoms of both conditions and make it harder to manage them effectively.

Are veterans at higher risk of sleep apnea due to PTSD?

A recent study has found a high risk of obstructive sleep apnea (OSA) in young veterans with post-traumatic stress disorder (PTSD). The study involved 195 Iraq and Afghanistan veterans who visited a VA outpatient PTSD clinic for evaluation. The results showed that 69.2 percent of participants had a high risk for sleep apnea, and this risk increased with the severity of PTSD symptoms. Furthermore, every clinically significant increase in PTSD symptom severity was associated with a 40 percent increase in the probability of screening as high risk for sleep apnea.

The study’s co-principal investigator, Sonya Norman, PhD, stressed the importance of screening veterans who come to PTSD treatment for OSA so they can be diagnosed and treated promptly. Sleep apnea is a known risk factor for various health problems such as hypertension, cardiovascular disease, diabetes, depression, worsening PTSD, and anxiety. Therefore, by treating OSA in young veterans with PTSD can not only improve their sleep quality but also positively impact their overall health and well-being.

How are sleep apnea and PTSD linked?

The link between PTSD and sleep apnea is strong, with many individuals experiencing both conditions simultaneously. In fact, individuals with PTSD are at a higher risk of developing OSA than the general population. The prevalence of OSA among those with PTSD ranges from 12 to 90%, compared to 17-22% in the general population. This indicates that PTSD is a major contributing factor to sleep apnea.

Studies have found that individuals who suffer from both conditions are more likely to experience severe symptoms of PTSD compared to those without OSA. This highlights the importance of diagnosing and treating OSA in patients with PTSD as it can lead to an improvement in overall mental health outcomes.

Furthermore, sleep-disordered breathing may be a sign of untreated OSA which has been linked with an increased risk of various health complications such as heart failure, dementia and certain cancers. Therefore, early detection and treatment is critical in improving overall health outcomes for individuals who present with symptoms of both PTSD and sleep apnea.

How fear and REM sleep relate?

Good sleep is essential for individuals with PTSD as it helps in reducing the fear associated with traumatic memories. Research reveals that sleep, particularly REM (rapid eye movement) sleep, facilitates fear extinction, a process in which the brain forgets the association of a neutral trigger with a fear response.

During REM sleep, the brain not only consolidates and remembers events but also works towards reducing the intensity of negative emotions attached to certain memories. Fear extinction and nightmares occur during REM sleep, indicating its critical role in mitigating anxiety-related symptoms.

Unfortunately, people with PTSD often struggle with sleeping problems such as sleep apnea, insomnia and frequent nightmares that disrupt their sleep pattern. When an individual wakes up from a nightmare, it disturbs their REM sleep and interrupts the vital process of fear extinction. Similarly, if someone has sleep apnea, then their tendency to experience disturbed REM sleep increases further.

Knowledge about the connection between REM sleep disturbances and anxiety disorders like PTSD is significant as it can inform new approaches to treat such conditions effectively. Finding treatments that promote a more restful night’s healing can help individuals resist succumbing to stressful intrusive thoughts and promote recovery by supporting neural pathways that promote adaptive coping mechanisms over time.

How to treat sleep apnea and PTSD?

Treating sleep apnea and PTSD requires a multidisciplinary approach, involving medical professionals and mental health experts. The first step in treating sleep apnea is to diagnose the condition through a sleep study, which involves monitoring a patient’s breathing patterns, heart rate, and other physiological indicators during sleep. Depending on the severity of the condition, treatment options can range from lifestyle changes such as weight loss or quitting smoking to more intensive interventions such as continuous positive airway pressure (CPAP) therapy or surgery.

In addition to treating sleep apnea, it is essential to address the underlying PTSD symptoms that contribute to sleep disturbances. This can involve a combination of medication and talk therapy such as cognitive-behavioral therapy (CBT), exposure therapy or eye movement desensitization and reprocessing (EMDR).

CBT is a type of therapy that focuses on changing negative thought patterns and behaviors, while exposure therapy involves gradually exposing patients to traumatic memories in a safe and controlled environment. EMDR is a type of therapy that uses eye movements to help patients process traumatic memories.


It is apparent that the relationship between PTSD and sleep problems is a complex and bidirectional one. OSA has been increasingly recognized as a significant contributor to this relationship. Individuals with both OSA and PTSD experience worse symptoms of both disorders, indicating the need for a comprehensive approach to treatment that addresses both conditions.

Although the initial causality of these disorders remains unclear, research suggests that sleep disturbance around the time of trauma exposure and stress-related hyperarousal may contribute to impaired REM sleep function.

The importance of effective treatment for these disorders cannot be overstated, as untreated PTSD and OSA can lead to severe health consequences. While evidence-based treatments for PTSD primarily do not address the crucial component of sleep disturbance from OSA, studies have suggested that CPAP therapy could benefit individuals with co-occurring PTSD and OSA significantly.

Though overall, addressing both conditions simultaneously appears to provide better long-term outcomes than treating each condition separately. Therefore, a multi-faceted approach is necessary to treat sleep apnea and PTSD successfully. By working with healthcare professionals and mental health experts, individuals can find the right combination of therapies that work specifically for them and improve their quality of life.

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