Can Sleep Apnea Cause Anxiety and Depression?

January 28, 2026
Jordan Weiner, MD

The relationship between sleep apnea and anxiety and depression is complex. People with sleep apnea report more symptoms of anxiety and depression. Many symptoms of sleep apnea – fatigue, poor sleep, problems with concentration or memory – overlap with symptoms of anxiety and depression.

Some patients with sleep apnea referred to me by their primary doctor have a history of anxiety or depression. Therapy and medication might be helping, but they still don’t feel quite right.

Once we treat the sleep apnea, their anxiety or depression symptoms often improve.

Sleep apnea does more than just make you tired. It changes your brain chemistry and structure in ways that can contribute to symptoms of anxiety and depression. Let’s look at how this can happen.

How Sleep Apnea Increases Symptoms of Anxiety

There are several ways sleep apnea can cause symptoms of anxiety, and these effects are real and measurable in the brain and body.

Stress Hormone Surges During the Night

When breathing stops during sleep, your brain knows you are in danger when it senses the drop in oxygen and increase in carbon dioxide. The brain reacts to this emergency by increasing cortisol and noradrenaline (related to adrenaline), the main stress hormones.

You might not be aware these events are happening, and you may not fully wake up. These apneas are repeated critical emergencies that occur throughout the night.

People with untreated sleep apnea can have dozens or even hundreds of these stress hormone spikes every night, night after night, week after week. The cortisol and noradrenaline levels can remain elevated during the day, causing increased feelings of anxiety.

GABA Levels Go Down

Gamma-amino butyric acid (GABA) is a calming brain chemical. It helps you feel relaxed.

Some people with sleep apnea may have less GABA in parts of the brain that control emotion. With less GABA, it may be harder to feel calm.

Glutamate Levels Rise

Glutamate is a brain chemical that excites nerve cells. It counteracts the effects of GABA.

Some people with sleep apnea may have higher glutamate levels in the parts of the brain that control emotion. When glutamate levels are high, they may feel more stressed and irritable.

Carbon Dioxide Buildup Triggers Panic

During apnea episodes, carbon dioxide builds up in your blood. High carbon dioxide levels trigger your brain to breathe, which you cannot do when your airway is blocked. You may wake up feeling like you’re suffocating.

Many patients tell me they wake up feeling as if they’re having a panic attack.

The Amygdala Becomes Hypersensitive and Hyperactive

The amygdala is the part of your brain that processes fear and emotions. It takes in information and processes it, deciding what your emotional response should be.

In people with sleep apnea, the amygdala may react much more strongly to negative situations.

This means situations that wouldn’t usually cause symptoms can trigger a fear response. The brain’s alarm system becomes too sensitive and overreacts.

Your Brain's Control Center Loses Control

Usually, the front part of your brain, called the prefrontal cortex, helps control the amygdala. It receives information from the amygdala and helps to decide your response. It helps you decide if something is truly dangerous or just seems that way. For example, if you set off your smoke detector by burning toast or searing meat—your amygdala is like the alarm going off. Your prefrontal cortex tells you, “Calm down, it’s just burnt toast, not a real fire.” But if your prefrontal cortex doesn’t send that calming message, the amygdala keeps sounding the alarm.

With sleep apnea, the connection between the prefrontal cortex and amygdala is weakened. The prefrontal cortex is less able to control the amygdala’s response. It’s harder to calm yourself down or think through your emotions clearly. You may feel more anxious.

How Sleep Apnea Worsens Symptoms of Depression

Sleep apnea also affects the brain chemicals that control mood. These changes may contribute to symptoms of depression.

GABA Levels Go Down

GABA is a chemical in the brain that helps you feel calm. Some people with sleep apnea may have less GABA in the parts of the brain that process emotions.

People with lower GABA levels may feel sad or lose interest in activities.

Serotonin Drops

Serotonin is an important brain chemical that regulates mood, sleep, and appetite. Sleep apnea lowers serotonin levels.

Low serotonin can contribute to feelings of sadness.

Other Issues Connected to Sleep Apnea

Besides changing brain chemistry, sleep apnea may contribute to symptoms of depression and anxiety in other ways, such as:

Hypoxic brain injury. When your oxygen drops over and over at night, it can slowly damage brain tissue. This isn’t a sudden injury, but damage that builds up over months and years. Brain scans in people with untreated sleep apnea show changes to areas of the brain that regulate mood.

Neuroinflammation. Sleep apnea is associated with chronic low levels of inflammation and, specifically, inflammation in the brain called neuroinflammation. Neuroinflammation from sleep apnea may increase symptoms of depression.

Sleep fragmentation. Even if apneas don’t fully wake you up, they break up your sleep patterns. Deep, restful sleep is disrupted, and REM sleep is shortened. This alone can cause symptoms of depression and anxiety.

The Misdiagnosis Problem

Here’s what makes this tricky: Symptoms of obstructive sleep apnea can look a lot like symptoms of anxiety and depression.

If you are being treated for anxiety or depression and your symptoms do not improve, it is important to consider the possibility that you may have obstructive sleep apnea.

Screening tools can be used by your primary care provider to determine whether you are at risk for obstructive sleep apnea and should have an overnight sleep study.

Warning Signs to Watch For

Your symptoms of anxiety or depression may be related to obstructive sleep apnea if:

You snore loudly.
Your breathing pauses during sleep. If your partner has noticed you stop breathing at night, you should be evaluated for obstructive sleep apnea..
You feel tired even if you sleep enough. If you get seven to eight hours of sleep but feel sleepy, your sleep quality may be poor.
You wake up with a headache. Morning headaches are a common sign of sleep apnea. These usually get better after you’ve been awake for a few hours.
Mental health treatments help but don’t fully solve the problem. If medications make you feel a bit better but not fully well, a sleep disorder might be present.

The Good News About Sleep Apnea and Mental Health

When sleep apnea is effectively treated, symptoms of anxiety and depression may get better.

Some patients who have struggled with anxiety or depression despite medication and other therapies may experience improvement in their symptoms.

However, many people have primary depression or anxiety that is not related to their sleep apnea and require ongoing therapy.

This doesn’t mean everyone with depression or anxiety has sleep apnea, and not everyone with obstructive sleep apnea has depression or anxiety.

However, sleep apnea should be considered when someone has symptoms of anxiety or depression, especially if regular treatments aren’t working fully.

What to Do If You Think You Might Have Sleep Apnea

If you have symptoms of anxiety or depression and any risk factors for sleep apnea, get checked out. Risk factors include:

Loud snoring
Witnessed pauses in breathing
Morning headaches
Daytime sleepiness
High blood pressure
Obesity or overweight
Large neck circumference
Age over 40

The evaluation starts with a visit to your primary care provider, who may order a sleep study. The study measures how often your breathing stops and how much your oxygen levels decrease while you sleep.

If the study shows you have sleep apnea, there are several treatment options. Depending on the severity of your sleep apnea, your doctor might suggest lifestyle changes, dental appliance therapy, or CPAP as the first step. If you can’t use CPAP, there are surgical options like Inspire therapy, AIRLIFT, or different pharyngoplasty procedures.

Even patients with mild obstructive sleep apnea may have symptoms of depression or anxiety that improve with treatment of their obstructive sleep apnea.

Don't Settle for Incomplete Treatment

If you’ve been treating anxiety or depression but still don’t feel better, keep looking for answers.

Ask your doctor about getting a sleep evaluation.

Your mental health is important. It’s important to find out what may be contributing to your symptoms.

Sleep apnea is treatable, but only if it’s diagnosed first.

About Dr. Jordan Weiner

Dr. Jordan Weiner is a board-certified otolaryngologist (ENT) and sleep surgeon specializing in surgical alternatives to CPAP therapy. He has performed over 500 hypoglossal nerve stimulation procedures with a 95% success rate, placing him in the top 1% of surgeons nationwide for this treatment. Dr. Weiner practices at Valley ENT in Scottsdale, Arizona.

Ready to find out if sleep apnea is affecting your mental health? Contact Weiner Sleep Surgery to schedule a consultation.

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Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. Do not stop taking prescribed medications without medical supervision.