Sleep Apnea: 7 Signs You Shouldn't Ignore, Its Psychiatric Impact, and Treatment

Dr. Tracey Marks, a psychiatrist, discusses obstructive sleep apnea (OSA), a common sleep-breathing disorder characterized by repeated pauses in breathing during sleep, leading to disrupted rest and low oxygen levels (hypoxia). She explains that these brief awakenings, often unnoticed by the individual, prevent restorative sleep by disrupting normal sleep architecture. The severity of OSA is measured by hypoxic events per hour: mild (5-15), moderate (16-30), and severe (over 30). The primary cause is often excess weight and fatty tissue around the neck, though anatomical factors like thicker necks, excess soft tissue, small chins, large overbites, and nasal obstructions (deviated septum, polyps) can also contribute, as can smoking.

The podcast highlights seven key signs of OSA, some of which are commonly overlooked. These include persistent, loud snoring; morning headaches; excessive daytime sleepiness (even after 7-8 hours of sleep); nocturia (waking more than twice to urinate) due to hormone release; erectile dysfunction linked to decreased testosterone; waking with a dry or sore throat from mouth breathing; and choking episodes during the night, often noticed by a bed partner. Dr. Marks emphasizes that while any single sign might not be definitive, a combination warrants evaluation, especially the choking symptom. A crucial nuance is that OSA's impact extends beyond physical symptoms, significantly affecting mental health.

Dr. Marks stresses the profound connection between OSA and mental well-being, noting that it can increase the risk of developing depression or worsen existing conditions, primarily due to increased inflammation. It's also associated with anxiety, including panic attacks, and can cause cognitive decline that is reversible with treatment but may become permanent if left untreated. She recounts patient experiences of improved thinking and memory post-treatment. Practical advice includes documenting symptoms and observations from bed partners, then presenting this information to a primary care doctor for a sleep study referral, particularly if depression or anxiety is resistant to conventional treatments and accompanied by fatigue and cognitive fogginess.

Treatment options include Continuous Positive Airway Pressure (CPAP) masks, dental devices to keep airways open, and surgical interventions like uvula removal. The broader implications underscore the importance of recognizing and treating OSA not just for sleep quality, but for preventing serious physical consequences such as high blood pressure, heart disease, stroke, and diabetes, as well as for preserving cognitive function and improving overall mental health. The episode advocates for a holistic approach to health, where physical conditions like sleep apnea are considered when addressing persistent mental health challenges, reinforcing the idea that "Mental Health COMMANDS A Seat At The Table."

"Obstructive sleep apnea is a common sleep-breathing disorder characterized by repeated pauses in breathing during sleep, leading to disrupted rest."

"Did you know it can also cause psychiatric problems?"

"When your oxygen level drops too low, your nerves send a signal to your brain to stimulate breathing so you can take in more air."

"Mild sleep apnea is when you have 5 to 15 hypoxic events every hour. Moderate sleep apnea is 16 to 30 events, and severe is when you have more than 30 hypoxic events every hour, that's a lot of times to be awakened in an hour."

"The most common cause is excess weight and the accumulation of fatty tissue around your neck, making your airway collapse during sleep."

"Sleep apnea has many negative physical consequences including high blood pressure, heart disease, stroke, and even diabetes."

"I'm talking about this today because sleep apnea can increase the risk of developing depression or worsen it if you already have the condition, and the cause is thought to be from increased inflammation."

"I've had patients who told me, \"They couldn't believe how much their thinking cleared up and their memory improved after they were treated for sleep apnea.\""

"The most common treatment is continuous positive airway pressure. It's a mask that you wear at night that looks like an oxygen mask, and it helps keep your airways open."

"If you already have depression or anxiety that won't get better with medication or therapy, and your thinking is kind of fuzzy, and you're tired all the time, take a look at some of these other symptoms to see if you have them."