sleep disorder and anxiety

[sumihari]

Dear doctor,

Is it possible for severe anxiety to be caused by poor sleeping posture and poor daytime posture, which subsequently leads to restriction in breathing?

I am disappointed with psychologists and doctors telling me my shortness of breath ( more like suffocation ) is only anxiety and prescribing pills. I keep on telling them, I can hardly breathe, I feel restriction in my throat, I feel like I am suffocating and it is affecting my sleep and it has got something to do with my posture as well. I know that on the rare occasions when I have slept through the night even for a few hours and  wake up with relaxed muscles, I don't feel anxious. But these doctors and psychologists look at me as if I am an idiot . My body is telling me otherwise.

I am dissapointed that once you have a label of anxiety in your medical record, then everything is a symptom of anxiety. If anxiety was the culprit, then pills and CBT, their breathing techniques and progressive muscle relaxation etc would have helped and it didn't. Physiotheraphy and postural correction has helped me tremondously, which to me indicates, it is not anxiety.  

I have a consultation with a specialist from the sleep apnea team this week. I seem to have all the criteria, small jaw, forward head with jaw pulling back, deviated septum. If indeed I have sleep apnea, then would you say it is best to treat that before attempting to fix the deviated septum. My deviated septum did not give me any problems until 2 years back when I developed the forward head. Are there any laser septoplasty methods?

Thank you for your advice

Sumi

[sumihari]

Hi Doctor,

Thank you for your response. I had my consultation with the sleep apnea specialist and have a sleep study in the next 1 - 2 months. He thinks if I had apnea it is most likely mild and not severe. I don't have the typical sleep apnea characteristics with the exception that my jaw is very retracted and tongue restricted and my throat is very restricted. This he thinks would contribute to some apnea and that the sleep study should be able to determine some answers. In the meantime he told me to stop doing the jaw exercises the TMJ specialist had me doing which may have contributed to the throat and jaw restrictions.

I really appreciate your response in this post and another one as it has helped me a lot and I was more confident at my consultations.

Thank you

Sumi

[Steven Y Park, MD]

Additionally, opening up your nose will help, but don't count on it helping to cure your sleep-breathing condition. (It's been shown to cure sleep apnea in about only 10% of the time.) The benefit to a septoplasty (and turbinoplasty) is that you'll breathe better through your nose in general, and it'll allow you to use treatment options (CPAP or dental devices) much more effectively. Lasers are a very old technology and is rarely used anymore with this type of procedure. It's the surgeon and his or her technique, not the fancy instrument, that predicts success.

[Steven Y Park, MD]

I've said it over and over on this forum as well as in my articles that many cases of anxiety is aggravated, if not caused by a sleep-breathing problem. Imagine if you stop breathing all of a sudden as you fall into deep sleep. You'll wake up gasping and choking, in a state of panic. This chronic stimulation of your sympathetic nervous system heightens your senses, making you en garde and on edge during the day. Almost invariably, people with an anxiety diagnosis have very narrowed airways that I talk about in my articles (see my articles on upper airway resistance syndrome and obstructive sleep apnea). If you wake up very quickly, your nervous system is hypersensitive. If you don't wake up quickly enough (after 10 seconds), then you had an apnea. Taken to the extreme, there are many reports of severe PTSD resolving completely years later, after an underlying sleep apnea condition was fully treated.