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What Is the Connection Between PTSD & Sleep Apnea?

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Nicholas Gibson

Updated 01/28/2023

Post-traumatic stress disorder (PTSD) and sleep apnea are both common conditions. Studies suggest that about 6 percent of people suffer from PTSD at some point in life.

Research also suggests that 26 percent of people between the ages of 30 and 70 are affected by some form of obstructive sleep apnea (OSA).

Post-traumatic stress disorder and sleep apnea can both have a serious impact on your ability to enjoy good-quality sleep and maintain healthy sleep habits. If you have either condition, you may wake up frequently during the night or feel overly tired during the day.

Scientific research suggests a link between PTSD and sleep apnea. While it’s unclear whether one causes the other, PTSD could make sleep apnea worse, and vice versa.

We’ll discuss what PTSD and sleep apnea are, as well as how each disorder can affect your well-being.

We’ll also dig into the science of the connection between PTSD and sleep apnea, as well as how this link could result in disturbed sleep, daytime sleepiness and other sleep issues.

Finally, we’ll explain how you can access expert help for PTSD and sleep apnea to improve your mental health, sleep health and overall quality of life.

What Is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder, or PTSD, is a mental health condition that can develop in people who’ve experienced a dangerous, terrifying or shocking event.

It’s common to feel scared or anxious after a traumatic experience. However, people with PTSD often display lasting symptoms that don’t improve over time and interfere with their daily life and mental well-being.

Common symptoms of PTSD include:

  • Flashbacks to a traumatic event, often with physical symptoms

  • Difficulty remembering specific details of the traumatic event

  • Avoidance of certain situations, people, places or feelings

  • Negative thoughts about yourself or life in general

  • A feeling that you’re responsible for or “guilty” about the event

  • Loss of interest in your hobbies

  • Nightmares and negative dreams

  • Scary, anxiety-inducing thoughts

  • Feeling startled or becoming tense easily

  • Angry, emotional outbursts

  • Difficulty falling or staying asleep

These symptoms can vary greatly in severity, and not everyone with PTSD will experience all of them. Our guide to the symptoms of PTSD in women goes into more detail about the signs you may notice if you’re affected by PTSD after a traumatic event.  

What Is Sleep Apnea?

Sleep apnea is a health condition in which your breathing temporarily stops during sleep. When this happens, your body may not get enough oxygen to function properly, causing you to experience interrupted sleep.

If you have sleep apnea, you may feel tired during the day, experience frequent headaches, develop a dry mouth, wake up often during the night to use the bathroom or have a reduced interest in sex.

When severe, untreated sleep apnea can cause sleep deprivation, which might make it difficult for you to focus on specific tasks or remember information during the day.

In women, sleep apnea is more likely to play a role in the development of mental disorders, including depression and anxiety.

If you sleep with a partner, they might inform you that you snore loudly, gasp for air while you’re asleep or have breathing that stops and starts.

Can PTSD Cause Sleep Apnea?

Post-traumatic sleep disorder is closely associated with sleep disorders, and there appears to be a link between PTSD and the risk of experiencing sleep apnea.

There are two types of sleep apnea. Central sleep apnea, or CSA, is caused by issues related to the way your brain controls the muscles involved in breathing while you sleep.

Obstructive sleep apnea, or OSA, is caused by issues that block or narrow your airway during sleep. For example, your tissues may close and block the airway, or your tongue may fall back into your airway and prevent you from breathing normally.

A large range of issues can play a role in the development of central sleep apnea and obstructive sleep apnea. These include your age, levels of certain hormones, lifestyle, heart health and body weight.

Even the physical structure of your neck and tonsils can affect your risk for sleep apnea, as the physical features of this part of your body may narrow your airway and restrict breathing.

So, is there a link between PTSD and sleep apnea? Sleep disturbances and a reduced level of sleep quality are common issues among people with post-traumatic stress disorder.

In fact, research suggests that sleep disturbances are a nearly universal problem among military veterans with PTSD.

Research has also found that veterans with post-traumatic stress disorder are far more likely to suffer from obstructive sleep apnea than the general public.

In one study, more than 69 percent of Iraq and Afghanistan war veterans who took part in screenings for PTSD were found to have a high risk of obstructive sleep apnea.

The researchers noted that study participants often didn’t show the classic risk factors for obstructive sleep apnea, such as being older or having a higher body mass index.

Other research has produced similar findings. For example, one study published in The Primary Care Companion for CNS Disorders found a high prevalence of obstructive sleep apnea among psychiatric patients with PTSD and major depressive disorder (MDD). 

In other words, those affected by post-traumatic stress disorder have a higher prevalence of co-occurring sleep apnea. That said, we don’t know if one causes the other.

When discussing PTSD, it’s important to keep in mind that sleep apnea isn’t the only sleep issue that may worsen.

Nightmares and insomnia, both of which can have a severe negative effect on sleep quality, are also common symptoms of post-traumatic stress disorder. These symptoms may make issues related to sleep apnea, such as lack of energy and daytime sleepiness, more severe.

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Can Sleep Apnea Make PTSD Worse?

Interestingly, the relationship between sleep apnea and PTSD seems to go both ways. Not only can PTSD make sleep apnea worse, but sleep apnea might also play a role in some post-traumatic stress disorder symptoms.

Researchers note that these conditions are often comorbid, meaning they occur in people simultaneously. In a review article published in the Journal of Clinical Medicine in 2022, experts noted that there’s likely a “bidirectional effect” between the two illnesses.

Part of this may be due to PTSD-related sleep disturbances affecting movement during sleep — an issue that might make sleep apnea more severe.

It’s also possible that hyperarousal and hypervigilance, which are common symptoms of PTSD, may increase your risk of waking up during the night as a result of sleep apnea.

While there’s a clear relationship between PTSD and sleep apnea, the full details of it still aren’t known to experts in the field. As such, more research is needed before we fully understand how PTSD may cause or worsen sleep apnea and vice versa.

How to Get Help for PTSD

Post-traumatic stress disorder is a treatable issue. Most of the time, the condition is treated with medication, therapy, changes to your habits and lifestyle or a combination of approaches.

If you have PTSD, it’s important to seek help from an expert. You can do this by talking to your primary care provider and asking for a mental health referral or connecting with a licensed psychiatrist in your area.

You can also use our online psychiatry service to connect with a psychiatry provider from home and take part in a virtual consultation.

Your mental health provider may recommend using antidepressants, participating in therapy or both. We offer online therapy as part of our range of mental health services, letting you get the help you need from the privacy and comfort of your home.

Our guide to therapy for PTSD goes into more detail about the specific types of therapy used to treat this common disorder.

How to Treat Sleep Apnea

If you think you might have sleep apnea, or if your partner has told you that you show symptoms while sleeping, it’s important to talk to a healthcare provider.

As part of the diagnosis of sleep apnea, your healthcare provider may ask you to keep a diary of your sleep over the course of several days. You might also be asked to take a blood test to check for hypothyroidism or other hormone issues that can affect your sleep.

In some cases, your healthcare provider may ask you to take part in a sleep study at a specialist center to analyze your sleep patterns and diagnose the specific type of sleep apnea you have.

Sleep apnea is treatable. Commonly, the treatment of sleep apnea involves healthy habits and the use of a breathing device while you sleep.

Your healthcare provider may recommend keeping yourself physically active, losing weight and reducing your alcohol intake. If you smoke, quitting may make it easier to breathe while you’re asleep, reducing the severity of your symptoms.

While sleeping, you may need to use a continuous positive airway pressure (CPAP) machine. The device uses continuous, mild air pressure to ensure your airway remains open during sleep.

Make sure to follow your healthcare provider’s instructions if you need to use a CPAP machine while sleeping.

In some cases, sleep apnea may need to be treated through surgery to adjust your jaw, remove your tonsils or other tissue in your throat or place an implant that makes breathing easier.

Your healthcare provider will work with you to identify the most effective way to treat your sleep apnea symptoms, regulate your nighttime breathing and improve your overall health.

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The Bottom Line on PTSD and Sleep Apnea

There’s a clear link between post-traumatic stress disorder and the symptoms of sleep apnea, with research suggesting a bidirectional effect between the two conditions. 

The good news is that effective treatments are available for both disorders. For post-traumatic stress disorder, this usually means taking part in cognitive behavior therapy (CBT) and using medication. For sleep apnea, it may mean using a CPAP machine at night.

With a focused, consistent treatment plan, it’s possible to successfully deal with both PTSD and sleep apnea, allowing you to enjoy better mental and physical health, as well as a higher quality of life.

If you’re concerned you may suffer from PTSD, you can get help from home by taking part in an online psychiatry consultation using our telehealth platform.

You can also learn more about processing trauma in our detailed guide to coping with traumatic life events. Get started today.

16 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. How Common Is PTSD in Adults? (n.d.). Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp
  2. Santilli, M., et al. (2021, October). Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study. International Journal of Environmental Research and Public Health. 18 (19), 10277. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8508429/
  3. Post-Traumatic Stress Disorder. (2022, May). Retrieved from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
  4. What Is Sleep Apnea? (2022, March 24). Retrieved from https://www.nhlbi.nih.gov/health/sleep-apnea
  5. Symptoms. (2022, March 24). Retrieved from https://www.nhlbi.nih.gov/health/sleep-apnea/symptoms
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  8. Causes and Risk Factors. (2022, March 24). Retrieved from https://www.nhlbi.nih.gov/health/sleep-apnea/causes
  9. Obstructive sleep apnea - adults. (2022, January 1). Retrieved from https://medlineplus.gov/ency/article/000811.htm
  10. Colvonen, P.J., et al. (2015, May). Obstructive Sleep Apnea and Posttraumatic Stress Disorder among OEF/OIF/OND Veterans. Journal of Clinical Sleep Medicine. 11 (5), 513-518. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410924/
  11. Fehr, B.S., Katz, W.F., Van Enkevort, E.A. & Khawaja, I.S. (2018). Obstructive Sleep Apnea in Posttraumatic Stress Disorder Comorbid With Mood Disorder: Significantly Higher Incidence Than in Either Diagnosis Alone. The Primary Care Companion for CNS Disorders. 20 (4), 18m02281. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30107101/
  12. Nappi, C.M., Drummond, S.P. & Hall, J.M. (2012, February). Treating Nightmares and Insomnia in Posttraumatic Stress Disorder: A Review of Current Evidence. Neuropharmacology. 62 (2), 576-585. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5154613/
  13. McCall, C.A. & Watson, N.F. (2022, January). A Narrative Review of the Association between Post-Traumatic Stress Disorder and Obstructive Sleep Apnea. Journal of Clinical Medicine. 11 (2), 415. Retrieved from https://pubmed.ncbi.nlm.nih.gov/35054110/
  14. Diagnosis. (2022, March 24). Retrieved from https://www.nhlbi.nih.gov/health/sleep-apnea/diagnosis
  15. Treatment. (2022, March 24). Retrieved from https://www.nhlbi.nih.gov/health/sleep-apnea/treatment
  16. American Psychological Association (APA). PTSD Treatments. Updated June 2020. Retrieved from https://www.apa.org/ptsd-guideline/treatments

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Katelyn Hagerty, FNP

Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.

She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.

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