Post-traumatic stress disorder (PTSD) may affect sleep in several ways, including increasing the risk of sleep disorders, including obstructive sleep apnea (OSA).

PTSD is a mental health condition that may develop due to a past traumatic event. It can cause a variety of symptoms, such as flashbacks of the traumatic event, feeling on edge, and anxiety. It may also affect sleep.

OSA involves brief pauses in breathing during sleep. It occurs when the muscles in the neck and head, such as the tongue, block the airway, cutting off airflow.

The article below examines whether there is a link between PTSD and sleep apnea, risk factors for sleep apnea, other ways PTSD may affect sleep, and treatment options for both conditions.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

A person looking out a window 1Share on Pinterest
Westend61/Getty Images

PTSD and sleep apnea often occur separately. However, there also appears to be a link between the two conditions.

A 2022 narrative review found that the incidence of OSA is higher in people who have PTSD than in those who do not.

Researchers do not completely understand the exact reason why individuals with PTSD appear to have an increased risk of developing sleep apnea. Different regions of the brain play a role in sleep-wake regulation and the anxiety response. However, these different areas of the brain interact.

Future research will continue to examine how this interaction may work.

Certain factors increase a person’s risk of developing sleep apnea, including the following:

  • Older age: The risk of sleep apnea increases as a person ages.
  • Male sex assigned at birth: Males are more likely to experience sleep apnea than females. They are also more likely to experience severe symptoms and develop the condition at a younger age.
  • Family history: Having a family history of sleep apnea or certain genetic disorders may increase the risk of developing the condition.
  • Changes in hormone levels: This may relate to endocrine disorders or occur due to other health factors.
  • Obesity: This condition may lead to increased fat deposits in the neck, which may lead to more frequent airway obstruction.
  • Heart failure or kidney failure: These conditions can lead to fluid retention in the neck, which may block the upper airway.
  • Large tonsils or tongue: These physical features may increase the risk of OSA because they can block the airway. Having a thick neck may also increase the risk.
  • Certain lifestyle factors: Smoking and drinking alcohol increase the risk of OSA.

Additionally, a small 2015 study on veterans indicated that greater PTSD symptom severity had links to an increased risk of receiving an OSA diagnosis.

PTSD often adversely affects sleep. According to the U.S. Department of Veterans Affairs, almost everyone with PTSD has some difficulty sleeping. Two of the most common sleep issues that occur with PTSD include nightmares and insomnia.

Nightmares can include vivid dreams that lead to physical symptoms, such as kicking and screaming during sleep. In some instances, nightmares replay the traumatizing event. The prevalence rate for nightmares in people with PTSD varies greatly and may range from 19% to 96%, according to a review of research from 2019.

Insomnia is also common in people with PTSD. It refers to trouble falling or staying asleep at least three times a week. Nightmares and insomnia often occur together. For example, falling back to sleep after a nightmare may be difficult.

PTSD may also affect sleep in additional ways, such as:

Difficulty sleeping can affect mood, memory, and concentration. In the long term, it can also increase the risk of the following health conditions:

Treatment for PTSD and sleep apnea is important for overall health. Although it may vary, treating one condition may positively affect the other.

Individual treatment needs may vary. In some instances, a combination of treatments may be more effective.

Treatment for OSA may include:

Treatment for PTSD may include different types of psychotherapy and medications.

Post-traumatic stress disorder (PTSD) is a mental health condition that may develop after experiencing a traumatic event. It can lead to a range of symptoms and affect sleep. PTSD may increase the risk of obstructive sleep apnea (OSA). It also may lead to other sleep disturbances, including insomnia and nightmares.

People need to speak with their doctor about which treatments for PTSD and OSA may work best for them. Treatment for OSA may include lifestyle changes, breathing devices, and orofacial therapy. Treatment for PTSD may involve medications and psychotherapy.