Have you ever woken up feeling sleepy even though you’ve had enough hours of sleep? Have you ever felt like you didn’t want to get out of your cozy bed because of the winter blues?
You may have depression or anxiety caused by sleep apnea.
Treatment for obstructive sleep apnea focused on the obvious things: snoring, panting, daytime sleepiness. But a new study suggests they may be missing something equally important.
Research published in JAMA network opened found that middle-aged and older adults at high risk for sleep apnea are about 40% more likely to experience depression, anxiety or psychological problems.
Among people who entered the study mentally healthy, those at high risk for sleep apnea were 20% more likely to develop mental health problems over time.
“The study highlights the urgent need for integrated screening and support for both sleep and mental health,” the researchers wrote, although they did not reveal a definitive cause and effect.
The link between sleep and mental health emerged slowly, just as it did before the 1960s, when medicine focused on the physical symptoms of sleep apnea, also called Pickwickian syndrome, after the chubby boy in Dickens who kept falling asleep.
The mind and body were treated separately, but that began to change in the 1980s, when early clinical studies showed that a significant percentage of sleep apnea patients also struggled with anxiety or depression.
Sleep apnea affects mental health through multiple pathways, most of which operate outside of conscious awareness.
Sleep fragmentation comes first. Repeated awakenings, often unnoticed by the sleeper, prevent deep, restorative sleep. The result: chronic fatigue, irritability to hair pricks, maximum sensitivity to stress.
Then there is a lack of oxygen. Each pause in breathing starves the brain, a condition called intermittent hypoxia.
Over time, this changes crucial areas such as the hippocampus, which controls memory formation, and the frontal cortex, which controls emotional control and decision-making.
There is some evidence that sleep apnea alone can cause early cognitive decline, affecting attention, memory, and executive functions, even in otherwise healthy individuals. It acts as what researchers call a “brain drain.”
Some researchers are examining sleep microstructure, the fine-grained architecture of sleep stages, looking for patterns that predict mental health complications.
However, the message for readers is clear: loud snoring, waking up tired despite adequate time in bed, or unexplained mood swings are all discussions you may want to have with your doctor.
