Can Insomnia Cause Sleep Apnea? The Truth Explained

Sleep is essential for physical restoration and mental clarity, yet millions struggle each night with sleep-related issues that affect their quality of life. Two of the most common—and often misunderstood—conditions are insomnia and sleep apnea. While they are usually treated as separate disorders, many people begin to wonder: can insomnia cause sleep apnea? This question opens the door to a deeper look at how these conditions might influence each other, either by triggering or worsening underlying sleep dysfunctions.

How Insomnia and Sleep Apnea Overlap (Comorbid Conditions)

First, it’s well established that insomnia and sleep apnea frequently occur together. This combined presentation is often referred to as COMISA (co-morbid insomnia and sleep apnea).

Characteristics of the overlap often include:

• Frequent awakenings or nocturnal arousals
• Light, fragmented sleep
• Daytime fatigue and irritability
• Unrefreshing rest despite “sleeping” many hours

Because they share many symptoms, distinguishing which condition triggers the other can be tricky.

Why Insomnia Is Unlikely to Be a Primary Cause of Sleep Apnea

When specialists examine the mechanisms behind obstructive sleep apnea (OSA), they point to physical and anatomical factors, such as:

• Airway collapsibility (relaxed throat muscles during sleep)
• Obesity or fat deposits in the neck or tongue
• Craniofacial structure (jaw, soft palate, nasal passages)
• Upper airway resistance syndrome (UARS) as an intermediate state

Insomnia, in contrast, is primarily a disorder of sleep regulation—hyperarousal, circadian misalignment, cognitive-emotional factors, and behavioral habits. While insomnia stresses the system and causes sleep deprivation, it doesn’t by itself change airway anatomy.

How Insomnia Might Contribute to or Create a Favoring Environment

Even though insomnia probably doesn’t directly cause apnea, there are several pathways through which chronic insomnia might increase the risk or worsen a latent apnea tendency. Consider:

• Muscle tone decline from sleep deprivation: Chronic insomnia leads to systemic fatigue and potentially reduced neuromuscular control. Over time, the muscles that help keep the upper airway open may become less responsive during sleep, making collapse more likely in vulnerable individuals.
• Altered breathing regulation: Sleep deprivation can influence autonomic balance (sympathetic/parasympathetic tone) and the threshold for arousal. These shifts might make someone more susceptible to breathing instabilities or hypopneas at night.
• Frequent awakenings leading to lighter sleep: Because insomnia keeps you in lighter sleep stages, a mild airway narrowing or collapse is more likely to trigger an arousal (i.e., you wake up) rather than being tolerated silently. Over time, the pattern of breathing instability might stabilize into recognizable apnea.
• Cumulative stress on respiratory control systems: Insomnia may lead to oxidative stress, inflammation, or subtle remodeling of respiratory control circuits—factors that might exacerbate underlying vulnerability to sleep-disordered breathing.

Thus, insomnia can act as a facilitator or accelerant rather than a root cause.

When “Insomnia” Masks Early Sleep-Disordered Breathing

An alternative possibility is that what feels like primary insomnia is, in fact, an early or mild form of sleep-disordered breathing (SDB) masquerading as insomnia. Some people may awaken frequently due to small airway resistance events or subtle airflow disruptions that don’t meet formal apnea criteria but still fragment sleep. Over time, these may evolve or be recognized as true apnea.

This potential scenario is consistent with observations in sleep medicine:

• Many people diagnosed with insomnia only later uncover sleep apnea when a sleep study is performed.
• Patients with mild SDB or UARS sometimes present clinically as insomniacs.
• The natural history might move someone from a “pure insomnia” presentation to a combined COMISA picture.

So rather than insomnia causing apnea, insomnia might be an early warning sign of breathing stress during sleep.

Clinical Clues That Suggest More Than Insomnia

If insomnia alone were at play, certain red flags might be absent. But when sleep apnea is lurking, there are hints you or clinicians should watch for:

• Snoring or gasping/choking sensations at night
• Witnessed breathing pauses
• Unrefreshing sleep, even with sufficient “hours”
• Morning headaches or dry mouth
• Frequent micro-arousals (you wake up but may not fully remember)
• Worsening daytime sleepiness despite insomnia treatment
• Neck or upper airway anatomical risk factors

If insomnia therapy (behavioral, cognitive, or pharmacologic) is only partially effective, these signs should prompt consideration of a sleep evaluation.

The Progression Model of Insomnia to Sleep Apnea

This cascade helps explain how insomnia can lead indirectly to a breathing disorder without requiring direct causation.

What Should Someone Do If They Wonder Whether Their Insomnia Is Masking Sleep Apnea?

• Keep a detailed sleep diary: Note bedtimes, awakenings (with approximate timing), any gasping or choking sensations, and daytime symptoms.
• Consider referral to a sleep specialist: Even in the absence of obvious apnea, if insomnia is resistant to standard therapies, a full overnight sleep study or home sleep test is reasonable.
• Involve multidisciplinary evaluation: A psychiatrist in Los Angeles treating insomnia should coordinate with sleep medicine or ENT specialists when comorbidity is suspected.
• Adopt supportive sleep-friendly habits: Avoid alcohol, maintain consistent bedtime routines, limit screen exposure, and optimize your sleep environment.
• Monitor airway risk factors: Be aware of weight gain, neck circumference changes, nasal congestion, or other structural contributors.
• Use incremental trial of therapies: If a mild apnea is diagnosed, an oral appliance trial may reveal whether breathing stabilization improves insomnia symptoms.

The Psychiatrist in Los Angeles: What They Might Observe

A psychiatrist in Los Angeles often sees patients with insomnia, mood disorders, anxiety disorders, or depressive symptoms. From their vantage point:

• They may suspect that insomnia is secondary to psychiatric illness, but in some cases, repeated insomnia treatments fail to produce full relief. At that point, they might consider referring for a sleep study.
• Because psychiatric medications can affect sleep architecture, a psychiatrist is well placed to monitor for signs that insomnia is not purely psychological.
• In one instance, a psychiatrist in Los Angeles might notice that a patient’s depressive symptoms improve temporarily with insomnia therapy—but daytime fatigue and cognitive fog persist, prompting further investigation of an underlying sleep-disordered breathing.

In this way, psychiatrists can act as sentinel clinicians who help detect when insomnia may hide or coexist with breathing disorders like sleep apnea.

Role of Brain Health USA in the Sleep Landscape

Brain Health USA can play a supportive or connective role in several ways:

• Awareness & screening: They might conduct educational campaigns or online screening tools, prompting people with chronic insomnia to explore underlying sleep-breathing problems.
• Referral networks: They can partner with sleep clinics, pulmonologists, and even a psychiatrist in Los Angeles to guide patients toward comprehensive evaluation.
• Lifestyle resources: Through newsletters or webinars, they may offer better sleep hygiene guidance, stress reduction techniques, and bridging materials to help patients understand comorbidity between insomnia and sleep apnea.

Thus, even without intervening directly in brain function, Brain Health USA can act as a hub or advocate in the broader sleep care ecosystem.

Final Thoughts

So, can insomnia cause sleep apnea? The short answer is no—not in the strict, direct sense. But the more nuanced reality is that longstanding insomnia may act like dry kindling: making one more susceptible to igniting an airway-collapse disorder under the right circumstances.

Sleep medicine today increasingly recognizes the overlapping and bidirectional relationship between insomnia and sleep apnea, so vigilance is key.

If you or someone you know is wrestling with chronic insomnia, talk with your doctor or a psychiatrist in Los Angeles, and consider a referral to a sleep clinic. With collaboration and awareness—something Brain Health USA can help facilitate—you can move from fragmented rest to restorative sleep, whatever the underlying mix of disorders may be.

Strict reminder from Brain Health USA to seek a doctor’s advice in addition to using this app and before making any medical decisions.

Read our previous blog post here: https://brainhealthusa.com/why-talk-therapy-doesnt-work/