Empire State Today

Michelle Sands, Registered Dental Hygienist and Silent Night Therapy’s Sleep Apnea Director, stated that more Americans now suffer from both insomnia and sleep apnea, and there is a relation between the two.

"There is good evidence of a link between insomnia and sleep apnea, and they have both grown in Americans over the years," said Sands. "Sleep apnea is a life-threatening condition because it affects your breathing. If your body doesn't get enough oxygen while you're sleeping, it impacts everything in your life."

Sleep apnea is a sleep disorder characterized by repeated interruptions in breathing during sleep, leading to frequent awakenings and fragmented sleep. According to the American Academy of Sleep Medicine, the most common form, obstructive sleep apnea (OSA), occurs when the muscles in the throat relax excessively, causing a temporary blockage of the airway. This condition can cause loud snoring, choking, or gasping for air, often leading to multiple awakenings throughout the night. These interruptions in sleep can prevent the body from reaching deep, restorative stages of sleep, contributing to the development of chronic insomnia.

Research published at the National Library of Medicine has shown a complex, bidirectional relationship between sleep apnea and chronic insomnia. On one hand, the repeated awakenings caused by sleep apnea can lead to difficulty falling back asleep, resulting in insomnia symptoms. Conversely, individuals with insomnia may become hyper-aware of their sleep difficulties, leading to increased arousal and difficulty staying asleep, which can exacerbate underlying sleep apnea. This cycle can create a self-perpetuating pattern where each condition worsens the other, making it challenging to treat either disorder effectively without addressing both simultaneously.

"Diagnosing and treating patients with both sleep apnea and chronic insomnia presents unique challenges," said Sands. "Sleep apnea is typically diagnosed through a sleep study, which measures breathing patterns, oxygen levels, and other physiological parameters during sleep. However, the presence of insomnia can complicate the diagnostic process as insomnia patients may have difficulty falling asleep during the study, leading to under-diagnosis of sleep apnea." Similarly, she said treating sleep apnea with Continuous Positive Airway Pressure (CPAP) therapy can be challenging for insomnia patients as the discomfort of the mask and machine may exacerbate their insomnia symptoms. A tailored approach is often necessary, combining treatments like CPAP with cognitive behavioral therapy for insomnia (CBT-I).

Addressing both sleep apnea and chronic insomnia requires an integrated treatment approach that considers the interplay between the two conditions. According to Harvard Health Publishing at Harvard Medical School, patients with mild to moderate sleep apnea may be recommended weight loss strategies, positional therapy, or oral appliances in conjunction with CBT-I to manage insomnia symptoms. In more severe cases, CPAP therapy remains the gold standard for treating sleep apnea, but its success may be enhanced when paired with behavioral interventions that target insomnia. By addressing both conditions simultaneously, healthcare providers can improve sleep quality, reduce daytime fatigue, and enhance overall health outcomes for patients suffering from these coexisting sleep disorders.

According to Silent Night Therapy's website, Sands entered practice in 2011, bringing over 25 years of experience as a Registered Dental Hygienist. Currently, she holds position as Sleep Apnea Director. The practice is currently focusing on a holistic approach to help their patients recover completely, starting with quality sleep.