Sleep Apnea and Insomnia: Important Differences to Know

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There are literally dozens of sleep disorders recognized by the International Classification of Sleep Disorders (ICSD-2), including sleep apnea and insomnia. Surprisingly, having both Obstructive Sleep Apnea (OSA) and insomnia can be a common occurrence. A study concluded that nearly the same amount of those who sought treatment for OSA were also found to have insomnia and vice versa.

If you have sleep apnea and also experience anxiety or depression, you could have sleep apnea and insomnia, so a visit to a sleep specialist might be in order. A sleep specialist will help you determine if you should complete a sleep study, or a behavioral therapy recommendation may be made for insomnia. 

The relationship between sleep apnea and insomnia may be confusing to process, but think of it as a car engine that’s not starting. It could be because of a dead battery, bad alternator, dirty spark plugs, or even cold weather—but the mechanic has to investigate what’s causing issues with the engine. If sleep apnea was the engine, insomnia could be a possible cause. 

Are Sleep Apnea and Insomnia the Same?

Sleep apnea is a condition where the individual’s breathing gets interrupted during sleep, while insomnia is a condition where an individual has difficulty sleeping. The majority of insomniacs may be aware that they could have sleep breathing issues that cause them to stay awake at night but they may not connect their sleep breathing problems to insomnia.

This is why you see many people with sleep apnea also experiencing insomnia, but simply chalk it up to an ill-timed cup of coffee in the afternoon. 

Are Sleep Apnea and Insomnia Related?

Sleep apnea and insomnia are related in that insomnia is a symptom of sleep apnea. What this means is that if you have sleep apnea, it’s likely you’ll experience insomnia. Your sleep apnea will interrupt your breathing during sleep and likely wake you up, so that’s another reason why some may erroneously attribute what could be sleep apnea as insomnia.

Insomnia’s symptoms include waking up too early in the morning, the inability to fall back to sleep, and going through episodes of uncomfortable or disturbed sleep. If your sleep apnea wakes you up, then it’s likely you’ll experience any of those events as a consequence. 

What’s the Difference Between Sleep Apnea and Insomnia?

The main difference is cause. While there are three different types of sleep apnea, the most common one is OSA. OSA is typically caused by a physical condition that causes airflow blockage. That blockage may cause someone to have trouble breathing normally while sleeping, and then their nervous system will wake them up so they can take a breath. If someone who is already prone to anxiety, stress, and depression experiences this, it’s likely they’ll have trouble falling back asleep for the night which could create an insomnia event. 

Insomnia can be caused by hormonal or mental conditions, such as depression, stress, anxiety, and menopause. Substances like nicotine, caffeine, excessive alcohol, drug abuse, and over-the-counter drugs can also cause insomnia.

Can Sleep Apnea Cause Insomnia?

Sleep apnea can cause insomnia indirectly. In this case, insomnia is a symptom of sleep apnea. If you’ve ever woken up gasping for air in the middle of night, it’s likely you had trouble falling back asleep—one of the hallmark symptoms of insomnia—and thus, the sleep apnea caused the insomnia.

Research also suggests that diagnosing patients for insomnia requires extra care to ensure the patient does not also have OSA.

Does CPAP Help With Insomnia?

Treatment for OSA is usually CPAP therapy, a machine that sends constant pressurized air into the airway to ensure it stays open during sleep. As a result, those on CPAP can also find relief for their insomnia. Certain lifestyle modifications can also help improve both conditions, such as regular exercise, weight reduction, healthy diet, and quitting smoking or alcohol consumption.

You may have noticed that sleep apnea is more physiological while insomnia symptoms can be largely psychological. Like maintaining a healthy diet and exercise regimen, getting a good night’s sleep is imperative to your overall health. Sleep allows your body to rest and restore energy so it can carry out its important physiological and psychological functions.

That’s why it’s crucial for you to understand the differences and similarities between sleep apnea and insomnia, as well as when it might make sense to complete a sleep study. If you do start CPAP therapy for sleep apnea or insomnia, it’s also worth looking into behavioral therapy as it’s been proven to improve CPAP therapy compliance.

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13 thoughts on “Sleep Apnea and Insomnia: Important Differences to Know”

  1. Thanks for sharing the good tips. Really Helpful for Patients suffering from Insomnia.

    My Mother was also suffering from this problem since a long time. After recommendation from one of my relatives, I took her to The Center for Sleep Medicine center in Chicagoland. Its been a year since then and she has completely recovered from it.

    I would recommend people dealing with this problem to consult with sleep specialist and recover soon from it.

    1. Hi Nidish
      As u mentioned Its been a year since then and she has completely recovered from it.?

      I’m also suffering from this problem since a long time I has been researching way to get rid by this sypthom I didn’t get back recovered please kindly advise me

  2. Thank you for this article. I have insomnia and have been unable to fall asleep with the CPAP. My doctor did not run any tests to rule out other health issues. It follow healthy bedtime practices. It is frustrating to have them treat you like you are a mental case when they don’t understand the complex nature of the problem.

  3. Many times sleep doctors run people through with a prescription for cpap/apap machine with very little help. Sleep techs can be more help if you can get access to one. I have insomnia both before and after cpap. I looked at my sleep data with a program called Sleephead, see cpaptalk.com for more info. I have a pattern of severe sleep apnea starting between 2 and 4 am. That’s when I wake and can’t get back to sleep. Been going on for several years. Think it’s because I tie to my back and can’t breathe out against the increased pressure from the machine. So lately I’ve been trying brisk walking to strengthen my lungs and also been doing tongue and throat exercises for sleep apnea. If this doesn’t help enough, I will return to my sleep clinic again and insist on trying a bipap machine, no pressure on exhale.

    1. Hi Sylvia,

      You know if you have questions about your treatment, you can call one of our CPAP Experts at 1-800-356-5221. They can give you some tips if you’re stuck in your treatment. Insomnia is difficult enough to deal with, but maybe there are some options you haven’t explored yet?

  4. I wake up after almost the same duration of sleep everynight, for months (4-4.5hrs per night)..It takes hours to get back to sleep,that’s even if I do..I am a mild snorer,have never been known to snore or choke..its impossible to fall asleep during daytime hours,regardless of how exhausted I am,and they insist I have Sleep apnoea.. This whole sleep industry is just Big business gouging a buck from people who are crying out for help..

    1. Hi Kevin, i’m sorry to hear that you are not getting very good sleep. Have you had a sleep study? If not, I would strongly recommend you speaking with your doctor about having one. If you were diagnosed with Sleep Apnea, after having a sleep study, are you currently on some type of Sleep Therapy? If not, you may benefit from using a CPAP machine, or some other therapy that your doctor would prescribe as medically necessary.

      Our goal is to help customers get a better nights rest! Even though, it may be hard to grasp the concept of being required to use some form of CPAP Therapy at first, the therapy can and has changed many lives!

      If you would like to speak with us regarding any aspect of CPAP Therapy, please feel free to reach us at: 1-800-356-5221, or e-mail us at: cpap@cpap.com.

      We wish you the best!

    2. Kevin, I was really interested to see your note. For many years I woke up after 4-4.5 hrs with a serious headache and serious fatigue all day. So I had an overnight sleep study done. I was told I have moderate sleep apnea and was set up with a ResMed CPAP machine. I started using it and the machine reported <5 events each night and no mask leaks. The app that comes with the machine excitedly told me I was doing great and should be feeling huge benefits soon! Only problem: I was still waking up after 4-4.5 hrs with a splitting headache and was still super fatigued all day. When I reported this I was asked if the mask was comfortable (it was).The pressure and humidity on machine are automated, so that was not the problem. I was told to add chin strap to prevent mouth leaks (I did). I was also asked if I took meds, drank coffee, drank alcohol (I don’t). I was finally told I just had to give it time to start to work. Well, it’s a month later. I’m still using my CPAP and I still wake up after 4-4.5 hrs with a headache, and am fatigued all day. So far the only change I’ve experienced is having less money and having a big machine I have to maintain.. And the ongoing message from the CPAP peddlers that it’s my fault their tech doesn’t work – I just have to “gain confidence with my therapy”, whatever they hell that means. I’m about done.

  5. I READY ALL THESE STORIES OF C-PAP MACHINES, I HAVE BEEN ON AMBIAN FOR YEARS AND GOT GOOD SLEEP, NOW THEY WANT TO DO A STUDY AND SWITCH ME TO A MACHINE…OR SO I BELIEVE. AS THAT SEEMS TO BE THE WAY TO MAKE $$$ NOT MAKING MONEY OF SCRIPTS ANYMORE SO EVERYONE NEEDS A C-PAP MACHINE. SO HOW DOES ONE TEST FOR THE DIFFERENCE BETWEEN INSOMNIA AND SLEEP APNEA. NO ONE CAN ANSWER BUT WILLING TO COLLECT THE $$ FOR TESTS.

  6. I’ve read all the comments and stories about not sleeping properly and still not finding relief with the CPAP machine . For years I’ve not slept properly either and yes needed a CPAP too , which wasn’t helping much till I finally found the “right” sleep doctor ! A doctor who knows that there is a difference between sleep apnea and insomnia! This new sleep doctor put me through what’s called CBT cognitive behavioral therapy,, it’s therapy that retrains your brain and body on how to sleep . It took me about 7-8 weeks but it worked ! And know I’m finally able to sleep 6-8 hrs ! I still wake up now and then through the night but I’ve learned how to myself back to sleep . So my point is ,, look for a doctor who does CBT !

  7. This is follow-up to my previous comment above describing lack of effectiveness in using a CPAP machine: I went back to my primary care physician several months ago and reported my lack of progress on getting sleep. He speculated my apneas were due to chronic (nonalergenic) sinus inflammation, later confirmed via a CT scan. To reduce inflammation, he recommended a nasal steroid spray. He also recommended dietary changes including elimination of sugary foods, which can cause inflammation and which I definitely too much of. Result has been complete return to normal sleep without need for CPAP. Am hoping to ween off nasal spray soon. Anyway, it’s really concerning that my sleep doctor never even considered nasal inflammation or it’s remedies as a way to solve my problem. But not surprising. If he had, and it had worked, he would have lost a lifetime of revenue from selling me CPAP accessories. Sleep doctors are highly incented to conclude people need machines forever, and to treat a symptom rather than finding the root cause of the problem.

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