Memory loss, mood changes, depression, irritability , lack of concentration, difficulty staying asleep and  fatigue/ daytime sleepiness are symptoms that can be easily explained by a mental health disorder like depression, anxiety, PTSD or ADHD. 

Part of a thorough evaluation for mental health disorders is also ruling out and ensuring they not related to another condition. In fact some medical conditions are highly correlated to psychiatric or mental health conditions. Oftentimes people living with chronic diseases also have a mental health condition, speaking to the importance of taking care of the body and the mind as one and not separately. It is very important that when seeking mental health treatment for some of the symptoms noted that you are being screened for a common disorder called  obstructive sleep apnea (OSA). 

What Is Sleep Apnea?

It is a common sleep disorder in which there are brief interruptions of breathing during sleep. These episodes last 10 seconds or more and occur frequently throughout the night. The most common type of sleep apnea is obstructive sleep apnea

obstructive sleep apnea (OSA) which is caused by relaxation of soft tissue in the back of the throat and can block the passage of air. 

Because of the lack of oxygen, your body’s survival instincts kick in and wake you up just enough to start breathing again. Frequent awakening is not good for restful and restorative sleep.

You may also wake up frequently during the night, feel short of breath and may feel like they are gasping, chocking when then wake up. In some cases people may perceive this as anxiety or a panic attack. Individuals will sleep apnea often report mood disturbances, irritability, depressed mood, fatigue, poor focus, and memory problems – many symptoms that look exactly like a mental health condition.

How Do You Develop Sleep Apnea?

In obstructive sleep apnea it occurs due to the muscles in the back of the throat relaxing blocking off airway passage. Let’s talk about some common risk factors for OSA.

Risk Factors for Obstructive Sleep Apnea 

• Excess weight: obesity increases your chance of developing OSA. Fatty deposits in the neck can obstruct airways and breathing.
• Neck Circumference: people with thicker necks may have narrower airways
• Smokers: Smokers have 3x greater risk of developing OSA than non-smokers. This is due to inflammation and fluid retention caused by smoking.
• Older age and being male: Men have 2-3x risk of developing OSA as well as older adults. Women do have increased risk as they age. 

Red Flags To Talk To Your Health Care Provider About.

It is important to understand and be aware of your symptoms and advocate for your healthcare needs. Snoring can be a common sign, but not the only sign to look out for. Ask your partners or family if they have ever heard you snore when you are asleep or if you had noisy breathing, or have stopped breathing while asleep.  It is important to get the correct diagnosis because if your mood troubles, insomnia, irritability, poor concentration and fatigue are related to sleep apnea, even improving an underlying mental health condition with medications will not solve all the systems because they are coming from a cause outside of your mental health diagnosis. 

• Being told that you snore or stop breathing while you sleep 
• Frequent middle of the night awakening
• Waking up feeling like you are choking, gasping for air or feeling “panicked” 
• Excessive daytime sleepiness 
• Dozing off easily in the middle of the day
• Waking up with headaches 
• Poor focus, concentration and/or concerns about memory problems

Why Sleep Apnea Needs To Be Treated

It is more than just about “not annoying” your significant other or roommates hearing you snore from the room next door, treating sleep apnea is essential and necessary for your health.  In one study, it showed that treating sleep apnea decreased depressive symptoms and improved emotional wellbeing. The article also underscores the importance of correct treatment as certain psychiatric medications to treat sleep and depression can actually worsen sleep apnea, which in turn can worsen mood, sleep, concentration and memory. 

If your primary care doctor or mental health care provider suspects you may be at a high risk for sleep apnea they can provide you a referral to sleep medicine. Sleep medicine specialists have the tools to evaluate your sleep and provide any recommendations or follow up items to help you get a better, more restorative and restful night sleep. There are different different treatments for sleep apnea – in mild cases may include lifestyle changes only including weight loss, quitting smoking , sleeping in certain positions and treating nasal allergies if present. If symptoms are moderate to severe in addition to lifestyle changes a health care provider may also recommend other treatments like a continuous positive airway pressure machine or “CPAP”  that delivers pressure through various types of masks to keep your upper airway passages open.  There are also various surgical interventions that can be considered as appropriate.