Sleep Apnea and Insomnia: Important Differences to Know

💡 Key Takeaways

• Distinct Disorders with Overlap: Sleep apnea and insomnia are two distinct sleep disorders. However, it's common for individuals with Obstructive Sleep Apnea (OSA) to also experience insomnia. In fact, many seeking treatment for OSA are found to have insomnia and vice versa.
• Defining the Conditions: Sleep apnea involves interrupted breathing during sleep, while insomnia is characterized by difficulty in sleeping. Many with sleep apnea may experience insomnia but might misattribute it to other factors, like afternoon caffeine intake.
• Interrelation of Symptoms: Insomnia can be a symptom of sleep apnea. If sleep apnea interrupts your sleep, you might face challenges like waking up too early, difficulty falling back asleep, or experiencing disturbed sleep, all of which are symptoms of insomnia.
• Underlying Causes: The primary difference between the two is their cause. OSA is often due to a physical condition causing airflow blockage, leading to breathing interruptions. Insomnia, on the other hand, can be triggered by hormonal or mental conditions, substance use, or even certain medications.
• Treatment Considerations: If you have both sleep apnea and insomnia, it's possible that treating your sleep apnea with CPAP can also reduce symptoms of insomnia. It's essential to understand the differences and similarities between the two conditions and consider undergoing a sleep study if symptoms persist.

There are literally dozens of sleep disorders recognized by the 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.

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-related breathing issues that cause them to stay awake at night but they may not connect their sleep-related breathing problems to insomnia.

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

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.

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.

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.

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.