Stress is a common aspect of modern life. For many people in the Detroit area, stress is a daily reality they have to deal with. Dealing with stress can be much harder when a person has sleep apnea. Sleep apnea is common in people with high perceived stress, but many people with stress don’t know they have sleep apnea. This can lead to complications because sleep apnea may increase risks related to medications used to treat stress.

If you have high levels of perceived stress, you should consider that you might also have sleep apnea. Then talk to a Detroit sleep dentist about getting tested for sleep apnea and finding a sleep apnea treatment that works for you.

Stress Is Higher for People with Sleep Apnea

woman stressed out at work with coworkers handing her workPeople with sleep apnea have higher levels of stress than people without the condition. One study shows that the average person with sleep apnea likely has moderate stress compared to low stress for people without the condition. In addition, people with stress and sleep apnea likely also have high levels of anxiety and depression symptoms.

We don’t know the exact reason why people with sleep apnea have higher stress levels. It makes sense that having interrupted sleep would contribute to stress as it contributes to depression and anxiety. However, researchers note that treating sleep apnea with CPAP (continuous positive airway pressure) only reduces depression and anxiety levels, not always resolving them. This might be due in part to problems with CPAP therapy generally. Still, it might also link to the sympathetic nervous system activation that ties sleep apnea to chronic health problems like high blood pressure (hypertension).

Could Stress Cause Sleep Apnea?

Another interpretation is that stress might cause sleep apnea. Researchers forward this explanation in a study of nurses and other medical workers in Wuhan province treating COVID-19 patients. Using questionnaires, researchers evaluated 26 members of the medical staff at a hospital for stress and insomnia. Researchers used pulse oximetry, measured by a pulse oximeter contained in a ring, to estimate sleep apnea levels.

The results showed that ten participants met the criteria for moderate to severe sleep apnea, with an AHI (apnea-hypopnea index) of 15 or greater. They found that people with high-stress levels were about 50% more likely to have sleep apnea than those with lower stress levels.

The researchers used this data to say that the workers’ stress caused their sleep apnea.

Researchers tried to explain how stress might cause sleep apnea by looking at the activation of the hypothalamic-pituitary-adrenal (HPA) axis.

Chronic stress activates the HPA axis, which leads to lighter sleep. This, in turn, leads to upper airway instability, causing it to collapse more often, which causes obstructive sleep apnea by cutting off access to air. The result is hypoxic stress caused by oxygen shortage. This creates a cycle whereby stress leads to sleep apnea which increases stress.

It’s hard to know if this explanation is reasonable. The study is not large enough to make definitive conclusions about the link between stress and sleep apnea. The study design doesn’t help determine which condition causes which. The precise link between the conditions remains a mystery, though it seems definite that there is some link.

Challenges of Treating Stress and Sleep Apnea

One of the biggest challenges in treating stress and sleep apnea together is the frequency of undiagnosed sleep apnea. Detroit doctors can’t treat conditions they don’t know about.
Treating stress without also treating sleep apnea can cause problems. Doctors most commonly prescribe benzodiazepines for anxiety and stress. However, benzodiazepines pose a serious risk for people with sleep apnea: they can lead to acute respiratory failure.

Furthermore, it seems that treating sleep apnea without recognizing the link to stress can lead to poor results. Patients with high-stress levels have worse outcomes for many treatments. When treating sleep apnea, sleep doctors and Detroit sleep dentists should factor in stress reduction as part of their treatment.

Get a Low-Stress Treatment for Sleep Apnea in Detroit

The most commonly prescribed treatment for sleep apnea is CPAP. Unfortunately, this treatment can also be a stressful approach to care. CPAP requires extensive maintenance, including detailed cleaning and setup prior to use. This adds more stressful activities to a person’s already stress-inducing routine. Stress levels can be high, knowing that failure to properly clean CPAP can increase the risk of infection and other complications.

In addition, the CPAP mask can trigger anxiety. The close feeling of the mask and the air pressure in the nose and mouth can make people feel claustrophobic stress. People with PTSD, for example, have a notoriously hard time adapting to CPAP.

Fortunately, there are other approaches to sleep apnea treatment. Oral appliance therapy can be a low-stress approach to sleep apnea treatment. You simply put the oral appliance in your mouth, and it holds your jaw in a comfortable position that keeps your airway open. Cleaning is easy. For people with high-stress levels, oral appliance therapy might be the best approach for treating mild to moderate sleep apnea.

If you want to learn more about this CPAP alternative in Detroit, schedule an appointment with Detroit sleep dentist, Dr. Jeffrey S. Haddad. Please call (248) 480-0085 or use our online form to request an appointment at the Michigan Center for TMJ & Sleep Wellness, located in Rochester Hills near Sanctuary Lake Golf Course.