How sleep apnea is a root cause of mental health conditions, and pathways to healing

In this blog, you'll learn about:

• Understanding sleep apnea: What obstructive sleep apnea is and how it disrupts breathing during sleep.
• Importance of oxygenation: The critical role of oxygen in brain function, especially for mental health, and how sleep apnea affects it.
• Mental health impact: How undiagnosed and untreated sleep apnea can lead to or worsen conditions like depression, anxiety, cognitive impairment, and chronic fatigue.
• Treatment options: An overview of effective treatments for sleep apnea, including CPAP, BiPAP, oral appliances, and the Inspire System, and how each works.
• Compassionate care: The importance of addressing sleep apnea for overall well-being and mental health recovery.

My Dear Reader,

In the journey of understanding and treating mental health conditions, one often overlooked culprit is sleep apnea. As a clinician deeply committed to uncovering the root causes of emotional distress, to my surprise I have encountered numerous patients whose mental health dramatically improves once we diagnose and treat their sleep apnea. These patients have typically seen other doctors who did not screen for or diagnose this condition, which is critically important as you will learn below. This blog aims to shed light on how undiagnosed obstructive sleep apnea (OSA) can exacerbate mental health issues and how effective treatment can pave the way to better mental and overall physical health.

What is sleep apnea?

Sleep apnea is a serious sleep disorder where breathing repeatedly stops and starts during sleep, along with shallow breathing episodes. The most common type, obstructive sleep apnea, occurs when the throat muscles intermittently relax and block the airway. These pauses in breathing can last from a few seconds to minutes and can occur 30 times or more per hour.

The critical role of oxygenation

Our brains are incredibly energy-intensive organs. Each brain cell, or neuron, is packed with mitochondria—the powerhouse of the cell. Mitochondria generate energy in the form of ATP (adenosine triphosphate), a process heavily dependent on a constant supply of oxygen. When sleep apnea disrupts breathing, it results in intermittent hypoxia (low oxygen levels), which can significantly impair brain function and damage the mitochondria themselves.

Lower oxygen levels lead to the accumulation of “free radicals” and oxidative stress, which can damage our mitochondria, our cells, and our DNA.

Oxygenation and brain function

Oxygen is vital for brain function because:

• It fuels the production of ATP in mitochondria. ATP is crucial for all cellular activities and the maintenance of living processes in our bodies.
• Adequate oxygen levels help maintain cognitive functions, mood stability, and overall mental clarity. Inadequate oxygen levels lead to brain fog and cognitive impairment
• Chronic oxygen deprivation can lead to neuronal damage (damage to brain cells), contributing to various cognitive and psychiatric disorders.

Mental health conditions linked to sleep apnea

Undiagnosed and untreated sleep apnea can lead to twice the odds of developing the following chronic conditions, or if one suffers from them already it can worsen them:

• Depression: Sleep fragmentation and low oxygen levels in the blood can cause biochemical changes that affect mood regulation.
• Anxiety: The intermittent struggle for breath during sleep can lead to heightened anxiety levels.
• Cognitive Impairment: Poor sleep quality affects memory, attention, and executive functions.
• Fatigue and Irritability: Persistent sleep disruption leads to chronic fatigue, impacting daily functioning and emotional well-being.

Other chronic medical conditions linked to sleep apnea

Untreated sleep apnea also doubles the risk of suffering from each of the following chronic medical problems: Hypertension, Coronary Artery Disease, Heart Failure, Atrial Fibrillation, Stroke, Cognitive Decline and Dementia including Alzheimer’s Disease, and Parkinson’s Disease

Effective treatment options for sleep apnea

Diagnosing sleep apnea typically involves an overnight polysomnogram, a comprehensive sleep study that monitors your sleep cycles and breathing patterns. This may be performed in your home or at a sleep lab. Once diagnosed, several effective treatment options can help manage and mitigate the symptoms of sleep apnea:

1. CPAP (Continuous Positive Airway Pressure):
   • How it works: CPAP delivers a steady stream of pressurized air through a mask, keeping your airways open during sleep. The masks can be tailored to the contours of your face to help make the fit comfortable.
   • Benefits: It is highly effective in reducing apnea episodes, improving sleep quality, and enhancing overall health.
2. BiPAP (Bilevel Positive Airway Pressure):
   • How it works: Similar to CPAP, but with two pressure settings—one for inhalation and a lower one for exhalation.
   • Benefits: Often recommended for patients who find CPAP uncomfortable or have high pressure settings.
3. Oral Appliances:
   • How they work: Custom-fitted devices worn in the mouth to keep the throat open by repositioning the jaw and tongue.
   • Benefits: A less invasive option, particularly effective for mild to moderate OSA.
4. The Inspire System:
   • How it works: A surgically implanted device that stimulates the hypoglossal nerve, which controls tongue movement, to keep the airway open.
   • Benefits: An alternative for those who cannot tolerate CPAP, providing significant improvements in sleep quality.

Root Cause Psychiatry™ compassionate care and treatment

Understanding the profound impact of sleep apnea on mental health underscores the importance of comprehensive care and taking a Root Cause Psychiatry™ approach to identifying the root cause drivers of chronic mental health conditions. By addressing sleep apnea, we not only improve sleep quality but also make significant strides in mental health recovery. If you or someone you know is struggling with unexplained mental health issues, consider the possibility of undiagnosed sleep apnea. A proper diagnosis and tailored treatment plan can transform lives, bringing relief and restoring well-being.

In our quest for mental wellness, let us not overlook the silent disruptor that is sleep apnea. With empathy, a thorough evaluation, and effective treatment, we can pave the way to healthier minds and lives. If you suspect sleep apnea might be affecting your mental health, reach out to a healthcare practitioner to explore your options and take the first step toward healing.