How Sleep Apnea Can Cause Anxiety And Panic Attacks

December 8, 2009

As we approach the most stressful time of the year, the one thing that we all forget to do is to remember to breathe. Literally. Tension and stress causes a nervous system reaction that causes you to take short, shallow breaths, leading to carbon dioxide (CO2) retention. Interestingly, a recent study showed that increased levels of carbon dioxide has been shown to affect areas in the brain that triggers fear and panic attacks.


This makes sense since if you’re chronically oxygen deprived from not breathing at night due to sleep apnea, you’re going to build up carbon dioxide, which can increase the acidity levels in the amygdala, which is the area of the brain that processes fear and behavior. 


This biochemical reaction, along with generalized nervous system over-responsiveness that comes along with inefficient sleep, is a good reason for you to feel over-stressed, over-anxious, and on edge. I’ve also described a situation where your tongue suddenly collapses and obstructs your breathing, and you’ll wake up violently, in a state of panic, in a cold sweat, and with your heart racing. This happens much more commonly than you think.


This study makes me wonder what all the carbonated beverages are doing to us as a society.


What’s you’re take on this? Do you find yourself taking short, shallow breaths or even hold your breath when you’re stressed? Please enter your comments in the box below.

71 Responses to “How Sleep Apnea Can Cause Anxiety And Panic Attacks”

  1. Roger V on December 9th, 2009 5:18 am

    What about adrenalin’s role in anxiety? I understand that when long apneas occur, the body produces excess adrenalin.

  2. Steven Park on December 9th, 2009 6:42 am


    Absolutely! An apnea by definition causes a sympathetic nervous system response. This study merely isolated carbon dioxide’s effect on the brain’s fear and anxiety centers. I’m sure there are thousands of other mechanisms or pathways that apneas can cause.

  3. Marie on December 9th, 2009 8:31 pm

    Thank you for the interesting article. I’ve always had anxiety – generalized anxiety disorder, obsessive compulsive behavior and panic attacks. After I was diagnosed with sleep apnea and started using a cpap machine they went away!!!! I wonder how many other people suffer anxiety caused by a sleep breathing disorder.

  4. Steven Park on December 10th, 2009 3:53 am

    Marie, much more often than you think. There are even reports of severe PTSD going away completely after sleep apnea treatment.

  5. Lupe Watson on March 16th, 2010 3:15 pm

    My daughter has problems sleeping at night due to anxiety attacks.  How can sheget rid of the attacks and is there something that she can take to control them

  6. cindy on May 18th, 2010 8:29 pm

    I have been having episodes of high blood pressure, severe headaches, fast pounding heart,and sweating over the last 14 months. Episodes used to be once a month and never last more than 20-30 minutes. I feel fine once the episode ends. My doctor had me do 3 24hr catechlolamine tests. All 3 tests were 5 times above normal for metanephrines. I am scheduled for MIBG scans on May 26-28 2010 to rule our Pheochromocytoma.  I do have sleep apnea and stopped using my CPAP about  18months ago because it was causing me to wake up with the fast heart rate. I am starting to wonder if my symptoms are sleep apnea or if it's just a coincidence that these sporadic episodes of HBP, fast pounding heart rate could be Pheochromocytoma.  Can sleep apnea cause an increase in your metanephrines? I felt my CPAP was ramped to high, and that was causing me to wake up every couple hours with the fast heart rate. My only symptom prior to being diagnosed with sleep apnea was the headaches. What is your take on all of this? thank you, Cindy

  7. Steven Park on May 19th, 2010 6:10 am


    I’m not aware of any study that shows increased metanephrines from sleep apnea, but I wouldn’t be surprised if there is. You should go ahead and treat your possible pheo condition. However, if you have sleep apnea, it can cause similar symptoms, such as causing headaches, taking up with a fast heart rate, and sweating. It should be treated simultaneously. It’ll be interesting if you’re able to control your sleep apnea definitively—does it help your pheo-like symptoms. Good luck.

  8. jesus guzman on August 25th, 2010 5:57 am

    4 months ago I did A sleep apnea test but because Im very claustrophobic I didn’t do the CPAP.Soon as they but the CPAP mask on me I had A panic attack fear of in the last 10 days I went to the E/R five times.I now have anxiety attacks, shortness of breath, tremors and twitches,nervous breakdowns,pounding heart,insomnia and Im very depressed.The E/R Doctors told me I have sleep apnea and Im going to need A CPAP to sleep.what can I do Im still claustrophobic but I need it to live.what can I do.PLEASE CAN YOU HELP ME.Im very depressed .Thank You

  9. Steven Park on August 26th, 2010 3:58 am

    Mr. Guzman,

    There are other options for treating obstructive sleep apnea including oral appliances and surgery. Please check my Sleep Apnea Basics page on my homepage at

  10. Dave Harig on November 13th, 2010 6:05 pm

    This link is sooooo true I bet this is the MAIN cause of my anxiety and panic disorders. I have been battling with anxiety and panic attacks for 6 years. It is a degenerative condition that has progressed to the point now I live in a daily consistent panic attack. I do have some very real physical symptoms as well including strange pains that appear in my upper torso and constant eye floaters (the squiggly lines that pass through your vision).

    Some days I wake up and feel great, I have no floaters, I can take on the work and have no panic. Others days are the complete opposite but the common thread is that they are tied together (Panic, Difficulty Concentrating, Edgy/Irritable, Eye floaters and weird pains).

    I was diagnosed with Moderate OSA three years ago. I was given a CPAP machine but unfortunately for me it does not always work. My apneas are occurring somewhere in my throat that the air pressure concept can’t keep open. I went to an ENT this summer and had my tonsils and uvula removed as they were each the size of golf balls (ENT’s word not mine). Although this stopped my snoring it did not fix my OSA as my wife says now I sound like air is whistling in my throat when I sleep (she describes it as a silent snore). My panic attacks are so bad now that I can hardly function and I can guarantee it has to do with sleeping. You know you have a sleeping disorder when you are no longer tired anymore. This is a hard concept to explain but it is like your body is trying to fight though the constant tiredness so hard and for so long that your mind retrains itself to exist in this new state of awake’ness. The side effect of this “fighting though” the tiredness is the panic attack. Whatever chemical your brain is outputting to keep you alert is over stimulating the fight or flight reaction.

    Here’s the rub – I would like to think that OSA can be fixed by losing weight, wearing a CPAP or other surgical procedures but I am just not sure. I just found out this summer that Percy Harvin an NFL football player who suffered from constant headaches was diagnosed with OSA. If a man of his extreme physical condition can suffer from OSA I am convinced this is more of a generic build flaw in some peoples months and throats than it is a condition that can be treated. I smoked for 10 years and I think this had some effect in acting as a catalyst to the chronic apneas. I quit cold turkey some time ago because of how sever the attacks were. Anyone who has smoked a pack or more per day knows how bad it is to quit yet because of how bad my panic was and how each cigarette compound the panic attacks by at least double I quit as simply as changing from bottled soda to caned soda. I read something on the web about CO2 levels and panic attacks and then OSA and CO2. I will say that this CO2 deal has to be spot on. OSA and cigarettes both modestly increasing CO2 levels are what trigger and cause my panic attacks.

    Most recently I have joined a gym as I am 35lbs overweight and I think a large amount of that fat is in my neck. I hope (pray) that the combination of quitting smoking, losing weight, having tonsils/uvula removed and using a CPAP machine will cure my OSA thereby my panic attacks but I am not so sure as I have lost 15 so far, quit smoking, 6 months past surgery and it is worse than it has ever been. The more drastic OSA procedures are very expensive and my insurance does not cover them. I have read that OSA can return some years after these procedures as your mouth/throat can reform.

  11. Steven Park on November 13th, 2010 8:31 pm

    Mr. Harig,

    Thanks for your input. Removing your tonsils and uvula alone won’t cure your sleep apnea, unless you address your tongue definitively, and not using minimally invasive techniques. But before considering further surgery (soft tissue or jaw surgery), did you do everything possible to make sure that you’re CPAP options are exhausted? Did you ever use data from the CPAP machine to see what your AHI is during CPAP use? Did you ever consider a dental device for your sleep apnea?

  12. sarah a on November 16th, 2010 11:21 pm

    I am a 35yo slim healthy woman who’s recently been diagnosed with mild/moderate apnea. I was relieved as I’m active but feel like I’ve been fighting tiredness for years. I’m currently waiting for an oral appliance, which I opted for instead of CPAP (Dr suggested CPAP). About a year ago I began to have panic attacks. I put it down to a series of stressful life events but more and more I’m suspecting a link between the apnea and anxiety; or that apnea has made the anxiety worse. On the days when I wake up super exhausted, I’ve noticed I am much more prone to dizziness and panic. If I have a rare day when I wake up feeling less tired, I notice I have almost no symptoms.

    I guess some of this could be self-fulfilling (ie I’m so tired, now I’ll be more anxious), but I’m hoping that with improved sleep, I get improved anxiety.

    It’s been mindblowing to learn that panic and sleep COULD be linked. I thought perhaps stress/anxiety was why I was so tired, but the apnea may actually causing the anxiety?

    Fingers crossed that with my soon-to-arrive positional sleeper and oral appliance I get a decent sleep and maybe a break from anxiety too.

  13. Dave Harig on November 29th, 2010 9:18 pm


    Any suggestions on mouth appliances?

  14. Nancy on January 20th, 2011 1:42 pm

    I was diagnosed with anxiety about 10 years before I was diagnosed with Sleep Apnea. I followed a lot of methods to tone down the Generalized Anxiety Disorder (which was caused in large part by work stress) – meditation, exercise, therapy and drugs. I still take Celexa daily for controlling my anxiety.

    I don’t know if I had apnea that long before it was diagnosed or not, but I’ve had that under control for the past 4 years. So good on both fronts.

    Unfortunately, I have a bronchial infection & was given Combivent for it – which is adrenalin. So have had some serious hours-long anxiety/panic attacks again. I did NOT miss them.

  15. Natalie Mojsej on March 11th, 2011 1:10 pm

    I was hospitalized in September 2010 for an insect bite that turned into cellulitis and required iv and oral antibiotics. I had an anaphylactic reaction to the antibiotics that were being used to treat me and the allergic reaction was life threatening. After the allergic reaction was stopped and the infection was treated I was released from the hospital. Since that time I have had recurrent symptoms of numbness in my tongue and throat, dizziness, blurred vision and gasping/gulping for air. My blood pressure is also higher (140/80) now and before my hospitalization it had been 115/60 on a consistent basis. The symptons come and go at sporadic times and can last for minutes, hours or days. I have seen doctors specializing in endocrinology, infectious disease and psychiatry as well as my personal physician. The doctors all agree there is some physiological cause for my symptons that is causing anxiety. Since a culture of the insect bite was never taken I have been told it is nearly impossible to find the exact cause of the origin illness. My husband noticed that since my release from the hospital I wake up at night gasping for air and shoot straight up in bed. This only started occuring after my release from the hospital in September. He believes I have sleep apnea. Is it possible the illness is causing anxiety which is in turn causing sleep apnea? I am at my wits end. I went from being in excellent health to days where I can barely function. I am frustrated with all the doctors appointments I have been to with no specific diagnosis, treatment or cure. I have been told that this will get better in time. It has been over 6 months and I cannot possibly imagine continue to live with these symptoms. What should my next step in seeking treatment and what type of doctor would you recommed. I greatly anticipate your suggestions!

  16. Steven Park on March 11th, 2011 1:14 pm


    It’s more likely that you were always predisposed to sleep apnea anatomically, but the sequence of events after the insect bite tipped you over the edge. If does sound like you have sleep breathing problems, so you should see a sleep medicine doctor. Hopefully, once your sleep quality improves, your symptoms will improve significantly.

  17. karen on March 12th, 2011 4:05 pm

    i have had anxiety and depression for 6 years now. i am 32 years old. i have been having strange thinngs happening in my sleep. i will be dreaming that something or someone is choking me and i will try to speak but cannot and then i wake up abruptly. i recently had a dream where i was singing and all of a sudden i didnt have enough breath to get out the words and i woke up with a physical feeling like i would have died if i hadnt forced myself to wake up and breathe… very scary. i do have acid reflux. i feel horrible during the day, no energy,terrible anxiety. my problem is i have no insurance and cannot afford a sleep study. does this sound like sleep apnea. i would so appreciate any suggestions or help in this matter..

  18. karen on March 12th, 2011 4:12 pm

    i am a ministers wife and i am in desperate need of help. i feel like i am losing the battle with this. i am so overwhelmed by all the things that i need to do and want to do but i have no energy to do them. i am scared to death!!!!

  19. Steven Park on March 12th, 2011 4:35 pm


    Sorry to hear about your situation. It can be frustrating and difficult to suffer from this condition and not be able to afford the very expensive tests. The treatments can be expensive as well. Sometimes starting with the basics can help, before going on to formal diagnosis and treatment. Make sure you’re able to breathe through your nose. Try nasal saline and/or breathe right strips. Take care of any allergies if you have any. Don’t eat or drink alcohol within 3-4 hours of bedtime. Don’t sleep on your back. Practice deep-breathing exercises during the day (restorative yoga is a good option). There are a number of tongue exercises that can help. Even acupuncture is found to help somewhat. There are also inexpensive screening options for sleep apnea. Oral appliances can also help. These can be over $1000 and work very well, but sometimes, over-the-counter boil-and-bite mandibular advancement devices (under $100) can also help. One model is called Somnoguard Classic. Hope this helps.

    Unfortunately, there are major hurdles in allowing people with sleep-breathing problems to get treated, even if you do have insurance. This reminds me to do some more research on how you can take care of sleep apnea if you have no insurance. I’ll probably either write an article about it or do a teleseminar.

  20. karen on March 12th, 2011 5:01 pm

    when i was a child i broke my nose on monkey bars. i do have one nostril that is ubstructed . i cant breathe well through that side. throughout the day i will feel like something is shoved in my nostrils making it hard to breathe. i have had my heart checked, my lungs checked and they say nothing is wrong. the only thing i have been diagnosed with is diabetes. does what i described earlier about the dreams sound like sleep apnea? i understand if yoyu are not able to tell me that, but i thought i would ask. i literally cannot go on like this. the physical symptoms, the fatigue, the anxiety are just to much for me to deal with anymore.. its driving me crazy and i feel like i need professional help. i feel like if i KNEW what was wrong i could deal better but the not knowing and wondering is Hell on earth…

  21. Bill on March 12th, 2011 5:23 pm

    Karen, I think what your anxiety and exhaustion may stem from is actual over-breathing. When you can’t breathe thorough your nose, you end up breathing through your mouth. The problem with this is because there is nothing inhibiting our breathing we tend to over-breath without realizing it. Really try to slow your breathing down and take smaller breathes. DO NOT fill up your whole chest. This can lead to shortness of breath very quickly because our body interprets that wrong. Give this a try and see how you feel after a couple a few weeks. This may be way off the mark but think its worth a try.

  22. Justin on May 23rd, 2011 4:34 pm

    going on about 5 months now, i have been struggling off and on (way more on then off), with shortness of breath on a daily, regular basis. around 2 months ago i sought the help of a pulminary doctor. I have since had a lung funtion test, ashma test, cat scan, x-rays, and sleep study’s done. I have recently found out that i have sleep apnea and possibly narcolepsy. All other test’s have come back negative.still, the doctor cannot figure out what is causeing these breathing symptom’s all day, everyday. there will be little spirt’s from time to time where i feel much better, compared to usual, and can breath better (still not normal),but there short lived and it returns to troubled breathing, and has really disrupted my whole life. ive tryed inhalor’s and breathing treatments to no avail. Could it be that the sleep apnea is causeing me to have this breathing problem? Or could it be sumthing that has stemmed from the sleep apnea, such as sumthing with the heart? im just now beginging to be treated with CPAP machaine so i dont know if it will fix this long, ongoing issue. Hopefully you can give me sum suggestion’s and other routes to go with this issue..Thank you

  23. Justin on May 23rd, 2011 4:43 pm

    (added to above question)….with my shortness of breath, it seems if i make myself yawn, time and time again im able to get a good deep breath more times then not…im 27 years old, not to obese, could probably lose 20 lb’s..just never feel like i can get a good deep breath when wanted and always, constantly short of or just sitting around..thanks for the help

  24. Ahmed owolabi on June 26th, 2011 7:00 am

    I am from nigeria.i found your post very helpful.i have been having anxiety attacks about two year ago,but i got tired of it and decided to put a stop to it.i didnt know the cause so i decided to google the cause of my heart palpitation and found out it was anxiety disorder.i didnt want to go to the clinic at first because i thought breathing excercise could cure it but it helped but it didnt go,but it i went to the hospital and i was diagnosed with anxiety disorder and was prescribed with tryptizol the anxiety went away after two weeks(as my psychiatry lecturer taught us)but now after two weeks it has resurfaced and i cant concentrate and i’m in first year in medical school.i think it should be sleep apnoea because when i sleep on my side it gets better the next morning but sometimes i end up rolling on my back.pls help.i think it has to do with the accumulated co2 diffussing the blood brain barrier and ionizing to H+, now increasing my heart rate to compensate for d hypoxia and hypercapnia.pls what can i do,i cant concentrate in classes and my exams re nearing.pls help!!!any help would be appreciated.thank you sir.

  25. Steven Park on July 1st, 2011 6:24 pm


    Whether or not it’s sleep apnea, you’re still having obstructions with abrupt awakenings. This is also why it’s better when you’re on your back. It’s important to follow my basic recommendations first, before diagnosing and treating more formally.

    1. don’t eat or drink alcohol within 3-4 hours of bedtime
    2. use Breathe Rite strips or any other type of nostril dilators
    3. take care of any allergies or nasal congestion
    4. try using one of the simple over the counter boil and bite devices for snoring
    5. do breathing exercises all the time.

    If this doesn’t work, then you’ll need a sleep study. Your options then include CPAP, formal oral appliances, surgery, or orthodontic jaw expansion.

    Good luck!

  26. John on November 27th, 2011 8:15 pm

    Thank you for this article, it has helped me with the sudden onset of panic attackes.

  27. Yvette on December 21st, 2011 11:55 am

    This was very en lighting information. I have not been tested for sleep apnea, but all of my siblings have it and I seem to have some of the same symptoms. Some days I feel so exhausted when I wake up. It’s like I have ran 5 miles not stop and I need to get some rest. My husband wakes me up during the night to tell me to roll over on my side or stomach because I snore, and if he does not wake me up, I am awakened by simply choking.

    My anxieties arise when I am on the freeway and I do not have to be driving. After hearing so many other testimonies I am going to consider get the sleep apnea test to see if that is part of my problem.

  28. Steven Park on December 21st, 2011 5:57 pm


    Sounds like a great plan. Good luck.

  29. Mike M on January 11th, 2012 7:37 am

    I too have sleep apnea which would also trigger panic attack. I was divorced and single for 13 years and remarried 3 years ago which has literally been a God send. After being married only a short time my wife asked me if I would have a sleep study performed. Not to mention that respect my wife’s opinion, she also happens to be a registered nurse & registered respiratory Therapyst. She know I was suffering from severe sleep apena. She set it up with a coleage to have the sleep study. I was qquickly diagnosed and sent home with a cpap. I now sleep wonderful and never intentially go to sleep without my cpap on. I have had only one panic attack in the Last three years since using the cpap, and the one panic attack that I did suffer was from falling asleep on the couch shortly after eating when I did not have the cpap on. Thank God for my wife and for CPAP , i just can’t explain in the quality of life living without sleep apnea and panic attacks. P.S When i did suffer the lazt panic attack, I put on my cpap while standing up and just normal breathing the panic attack soon passed, I truly hope this is of help to anyone that might be suffering from similar conditions. Mike

  30. Rachel on January 25th, 2012 11:13 pm

    I was diagnosed with sleep apnea a few years ago. I recently have been having anxiety attacks and I have been very paranoid. I’m curious if my sleep apnea has something to do with that..?

  31. Richard on January 29th, 2012 2:15 pm

    I was diagnosed with OSA approximately 3 years ago and was treated with CPAP, which unfortunately didn’t produce any positive results in my quality of sleep. I too have chronic anxiety and morning fatigue which I believe is directly related to the poor quality of sleep as a result of OSA. About 2 years ago, I was seen by an orthodontist for a consultation for braces due to a cross-bite (note: I had previously had braces when I was a teen). One of the first questions he asked me was whether I had OSA. After he explained to me that my jaw structure is characteristic of someone with OSA, I met with an oral surgeon for an evaluation. Since then, I have been working closely with my oral surgeon, orthodontist, and dentist as I prepare for MMA with genioglossus advancement in approximately 1-2 months. I’ve read that this procedure has a >90% success rate in eliminating OSA, but am curious, Dr. Park, what your thoughts are on how successful this procedure truly is and whether patients who’ve had it have seen a reduction in anxiety-related symptoms as well as improvement in their quality of sleep.

  32. Steven Park on January 31st, 2012 5:39 am


    The MMA is a highly successful procedure (~90) but not without risks. When performed by an experienced surgeon, complications should be minimal. There are mixed opinions on obstructive sleep apnea and anxiety, but my feeling is that anything that helps you to sleep better can help with anxiety symptoms. Good luck.

  33. Chris alcantar on February 2nd, 2012 7:11 am

    I wake up violently @ night and i fell like im having a major heart attack. It’s truly a horrible sensation to wake up with every night. Ive woke up several nights from choking in my sleep. I suffer from bad anxiety a lot and panic attacks.

  34. Steven Park on February 2nd, 2012 9:40 am

    Mr. Alcantar,

    It’s likely you’re having obstructions that are causing you to wake up violently. These episodes may not last long enough to be called apneas, but either way, it should be treated like OSA. You should consider seeing a sleep doctor about this.

  35. Richard on February 8th, 2012 12:27 pm

    Dr. Park,

    Thanks for the response and your confidence in the procedure. Just to give you a quick update, I am scheduled for the MMA with genioglossus advancement on March 7th. I will do my best to provide you an update on the status of my sleep apnea and the quality of my sleep post-operatively. It may be a few months, but I will let you know.

  36. Johnson on February 14th, 2012 9:02 am

    I have trouble getting over the climax of a yawn for quite some time now. It feels as though I am choking. Sometimes I feel like take very shallow breaths and I wake up just before i fall asleep. There are also days when I wake up feeling like I have not slept at all. I have allergic sinusitis. Are they related? What do you think?

  37. Leroy Hargrave on February 16th, 2012 9:42 am

    I need to know what i can take before i start the sleep Apnea test so i can tolorate the test with out having a panic attack when i have to ware the cpap machine have failed in the past

  38. Jeremy on February 20th, 2012 10:37 am

    This has been the most help for me!!!!!!! I have seen many doctors and have been having problems with Sleep Apnea for a year now. Nobody likes to think that anxiety could be the culprit. But it is a dirty double bladed sword! You have to manage your anxiety in order to sleep.
    With restless sleep from anxiety and burst of adrenaline from sleep apnea……….plays tricks on your mind. You can feel anxiety, but sleep apnea is always in your mind.
    Manage your stress, meditate, and dedicate a solid 7-9hrs each night…….build barriers to reinforce this and do not deviate from it. I own my business but with my health condition…….I have no choice. Know your limitations! Managing your life is living.

  39. Brenda on February 27th, 2012 3:37 pm

    I have bad anxiety attacks also. I also have apnea but quit using the machine and now anxiety attacks are much more frequent. My doctor said I quit breathing 177 times during my sleep study. I find myself gasping for air, heart beating through my chest and racing thoughts. I’m going back to my CPAP machine to see if it will scale back or eliminate the panic attcks. Seems to me if you’re not breathing you brain would go into fight or flight mode thinking your being choked out.

  40. Zak Brown on March 20th, 2012 12:24 am

    Anyone experience this? I expected I had sleep apnea, heavy snoring, daytime tiredness, could also fall asleep in seconds and go immediately into deep dreams…then I started waking up in middle night with heart beating fast, feeling I could breathe. Went to ENT doctor and prescribed a sleep test. Went for sleep test, tossed and turned during the first part of the test (without a mask, to see if I met protocol for 2nd part of test with mask), fell asleep finally for only 30 minutes, woke up in panic, had to rip off all the electrodes and get out of the room. Literally couldn’t stop moving, walked around the building for hours. Turned out I stopped breathing 37 times in 30 minutes, diagnosed with severe OSA. Went another week, woke up in middle night, in panic again, and once again had to keep walking/staying in motion. Felt like I couldn’t breathe and I stayed up all night walking around my neighborhood, couldn’t stop moving. Ended up in ER next two days, felt hot, and felt like I was suffocating. Almost had to strap me to bed in ER since I wanted to get up and keep in motion. Next got sent to behaviour center for group therapy/CBT. Prescribed Ativan/lorenzapram which finally settled me down and I could stop walking. This went on and off for next few months. Had surgery to fix deviated septum, did fine in surgery, but in the recovery room they taped gauze over my nose which impeded my breathing, and the anxiety/panic started, first with feeling of body warming up (I had to rip the hospital slippers/socks off), then the pacing/walking mode started again. Went on for 3 days, literally walked around my neighborhood 24/7 for 3 days, and then it stopped instantly with a wave of calmness. Went to a computer class several weeks later, all of sudden room started warming up, I pulled off all my layers of shirts, but had to leave. Couldn’t sit in place and had to get moving/walking. This time it only lasted for the morning. That was a year and half ago, haven’t had another attack since (knock on wood). I did get the CPA way back and use it 100% of time. Nasal surgery also opened up my breathing/nasal passageways. And I went on heavy exercise cycling program. Probably a combination of things appear to have solved the issues.

    But…anyone else ever have the feeling that they couldn’t stay in place and had to get up and keep moving? Literally pacing back and forth in the house, then outside, I must have walked about 25 miles a day (for real!). I felt like the bus in the movie Speed — that couldn’t slow down below 50!

    I’ve seen mention of restlessness in limbs, but this was way beyond that. I think if they had strapped me to the table I would have ripped/burst the straps to flee and get moving.

  41. shana Fox on March 28th, 2012 11:19 pm

    I was in the hospital and noticed that I was having breathing problems at night. I also have asthma, but fortunately one of the nurses was willing to give me oxygen and I noticed that I felt much bettter and less anxious. That got me to thinking, so I asked my doctor if he could order an overnight pulse oximetry test…these are much easier and less expensive than sleep studies; you can ask your local oxygen company how they charge if you’re not insured, but otherwise most insurance covers this test. You just clip a sensor on your finger overnight and then they examine the data. This is a pretty easy way to get an idea if you have sleep apnea episodes and if your oxygen saturation is below a certain level, most insurance will cover an oxygen concentrator. Something to consider for those who can’t do the sleep study for whatever reasons….Good luck!

  42. Richard on July 14th, 2012 10:09 pm

    Dr. Park,

    When I last wrote on February 8, I said I would provide an update following my surgery. I underwent bilateral MMA with genioglossus advancement a little over 4 months ago. I still have several more months before I’m 100%, but I can already tell a difference in the quality of my sleep, not to mention the quality of my life. I cannot begin to describe the difference this surgery has made in my life. I no longer need to use a C-PAP and wake up feeling refreshed each morning. I have noticed that my anxiety has diminished, my concentration and attention has improved, and I don’t tire as easily. It’s amazing. Granted, it may be an extreme method for treating sleep apnea (not to mention pretty painful), but certainly well worth it IMHO.


  43. Judy on August 19th, 2012 3:19 pm

    I am so glad to find this information. I feel like I may now be able to get help. Nine days ago I had two vertigo episodes, which I have never experienced before. The first occurred as I was lying down; the second while rolling over in bed that night. I was terrified. I checked my blood pressure after the one at night, and it was very high. I have not had any more vertigo, but now I have experienced panic attacks accompanied by queasiness and lightheadedness. I have not experienced rapid heart beat or hyperventilation so I was puzzled in additon to living in anticipatory fear of my next panic attack.

    This makes sense, and I am going to get evaluated for sleep apnea ASAP.

    Here are some relevant facts to my situation:

    I have always been anxious and a worrier but have never felt panic.
    I have well-controlled diabetes without meds and controlled HTN.

    Four weeks before the vertigo, I had what I think was viral gastroenteritis that just knocked the wind out me for days.

    I had resumed my walking program slowly, and the day this started I walked 2 miles slowly, came home, took a shower and decided to lie down and read. (Oh, by the way, I had very bad sinus headaches almost regularlly since all the violent vomiting). I fell asleep during the afternoon while reading and woke up 2.5 hours later flat on my back which is most unusual because I never sleep on my back.

    I needed to get up and go to the bath room, and I felt like I was in a drugged sleep. I decided to lie back down, and as I reclined, the room begin spinning. I rolled over on my side and was terrified. It stopped within seconds. It occurred, again that night when I merely rolled over in bed. After It subsided, I got up very carefully to check my blood sugar and blood pressure. The sugar was okay, but the BP was way up.

    I called my doctor the next day. He reassured me that the vertigo was not a serious problem and added an additional BP med to my regimen.

    I then had a phone consultation with my ENT doc, who reassured me too and said it was probably due to a virus and suggested I get some otc Bonine. Oh, my GP also told me to take Xanax for the anxiety.

    Like I say, it has been 9 days since the vertigo. My BP is back to where it normally is, and I have discontinued the second BP med. My blood sugar is fine. I used Flonase, and the sinus pain is almost totally gone. Still I will suddenly feel intensely fearful and out of control and sometimes that comes with lightheadedness and queasiness. Xanax clearly relieves this a lot, but I don’t want to have to take much of that nor take it often. I want to know what is wrong and what I might can do to fix it.

    It was when I googled ‘panic attacks without hyperventilation or increased heart rate’ that I finally hit upon the carbon dioxide/vertigo connection and from there the sleep apnea/carbon dioxide connection.

    I am knocking on wood, but for the first time since this started, I feel some hope for resolution and understanding. I plan to try to get checked this week for sleep apnea.

    Thank you Dr. Park!!!

  44. Awet tsehaye on October 10th, 2012 8:59 am

    I feel shortness of breathing when i am sleep @ night n i feel heade ache when i am stand from my sleeping so what shall i do ?

  45. Julianna on November 5th, 2012 3:38 pm

    Have you found any link between an influx of testosterone (ie. through hormone therapy) and the increase of andrenaline and it causing additional panic attacks in a male who has sleep apnea? Adrenaline spikes when male is sleeping and abruptly woken (hence, fight-or-flight) and then unable to stop the adrenaline and then it becomes a panic attack? Thank you

  46. Daniel Marshall on November 26th, 2012 2:26 pm

    I have been having severe panick attacks, and high anxiety every day for about two years now. raicng heart, PVCs, high blood pressure, agorophobia. I underwent numerouse tests from my doctor to rule out any medical problems. Full blood work, thyroid tests, protable halter monitor(test heart health), and the list goes on.

    After countless visits to the ER with full out panick attacks, with blood pressure readings over 200/160 and heart rates over 200bpm, and after endless visits to my family Dr. without any oviouse cause for these attacks. My Dr. finally suggested I get tested for sleep apnea.

    Well off to the sleep clinic i go, 1500k.m. away (I live in rule northern Cananda). I doubted this could be th problem and though the test would not show anything. Was i ever wrong. Sleep study showed that I had 99 obstrutive events per hour, and showed that I only had about 2mins of deep sleep and REM sleep in totoal for the whole night. I am due to be set up with a CPAP machine, and I am eagerl looking forward to the improvments in my quality of life.

    I have noticed my sensaivity to CO2 levels and how it can cause my pannic atacks. whenever I work out o exert myself to the point of building up CO2 levels I feel an emediate anxiety attack. I also noticed my symptoms where more frequent when I drank alot of beer and soda, which are high in CO2 as well. Still have anxiety but saverity has gone down, and have not been to ER since I eliminated beer and soda from my diet.

    I am eagerly awaiting my CPAP treatments. Good luck to everyone out there with anxiety. If you have it, it is tottaly worth getting a sleep study done, and eliminated carbonated beverages from your diet.

  47. Erin on December 27th, 2012 2:46 pm

    My mother was diagnosed with OSA a year and half ago. She is also a long time smoker. About a year ago, she started having severe panic attacks and anxiety which I made her start seeing a psychiatrist and they started trying different meds. She has tried a variety of meds over last year and she doesn’t think they have helped any. She states the Anxiety is the worst in the morning but as the day goes on she starts to feel a little bit better. I took this response that the meds must be doing something she just doesn’t want to believe it. I was recently reminded of her OSA when I slept in the room next to hers recently. I started to revisit that maybe this could be a contributor. I am concerned because she is on 3 different meds for depression and anxiety. If I wanted to explore this further to see if this could be her problem would I request CO2 blood test? What else would help indicate if this was her issue versus a true anxiety disorder?
    Thank you,

  48. Steven Park on December 27th, 2012 8:53 pm

    Erin, I can’t say for sure without examining your mother, but in general, for people with both obstructive sleep apnea and anxiety, I recommend treating the sleep apnea definitively first, and then address any remaining anxiety issues that remain. Having multiple choking episodes at night can definitely leave anyone anxious in the mornings. Good luck.

  49. Geri on February 2nd, 2013 12:46 pm

    I would wake up with my heart pounding and feeling panicky. Couldn’t understand why and just recently I was diagnosed with severe sleep apnea. For the past 10 years my family complained about my extremely loud snoring, but it wasn’t until recently that I felt the effects of a restless night. I had the 2 part sleep study done recently and really did not sleep well in the clinic. The mask was very uncomfortable. I am a mouth breather, so it took a while to adjust breathing through my nose. I’m not sure if I should use the CPAP and try to get use to it or maybe the dental appliance. I know each one has it pros and cons, but I would like some feedback in using either one of these appliances.

  50. Chris on February 26th, 2013 2:49 pm

    This thread is really helpfull. I’m not yet sure if I what I have can be labeled as sleep apnea or not. To give a context, I snore a lot, and my girlfriend tells me that sometimes I choke when I sleep but just continue on without waking up. I usually drink a glass or 2 before bed as well as eat (bad habit)..I’m in a pretty good shape, very little fat % and eat very healthy.

    Last night, I woke up frantically in a panic, breathless, jumped out of bed and was fighting to throat was blocked feeling like someone was chocking me..and I couldn’t breath at all…feels like you’re about to die…its a very horrible position to be lasted maybe 10-15 sec…this is maybe the 8th time it happened within a year. I’m not sure what to do, I was going to start with the basic solutions and see if that works.

    Any help on pinpointing what i have and what I should do would help a lot!


  51. Carol on April 18th, 2013 9:33 pm

    I have been dealing with serious anxiety and depression that has disabled me for the last 10+ years. I have taken every medication available, had ECT treatments (electric wires connected to me intended to cause seizures), and years of therapy. Nothing has helped. I feel so hopeless and fearful that I will never get better.

    Then my husband decided to do a sleep study because he snored and held his breathe. I noticed this as I lay in bed at night unable to sleep. It was at this point that I began to research sleep apnea and came across the association between sleep apnea and anxiety and depression. I couldn’t believe that between all the therapists and doctors that I had been patients of (perhaps 15+), none of them had asked me anything about possibly having sleep apnea.

    My husband has long known that I snored so loudly that he would have to wake me up so that he could return to sleep. That is not the only indication that I may have a sleep problem. I have restless leg syndrome among other things. But never having been told about the connection, we never had reason to suspect…

    Now, I am scheduled to have my test in about 5 days. I will find out for sure whether I have sleep apnea. All indications are that I do. It is the first ray of hope I have had in years. I do not expect to be instantly cured, I only hope to receive some help as I get used to the CPAP machine. I know that I have issues to work on, but we may have finally found the answer to why nothing has worked, no matter how hard I tried to do all my therapists have suggested. There was something else wrong that kept me stuck and unable to get better. Seeing my doctors over the years has resulted in being sent home with another pill to the extent that the amount of medication I am presently on is immense. I have read that more medication only makes the sleep apnea worse. Hence, a vicious circle from which I could not escape.

    I feel that this is a wake up call for everyone I have worked with. I have suffered so much and so long. It all could have been shortened and helped with a simple question and test. It makes me want to cry. My husband has suffered along with me, trying to support me through it all.

    I am also concerned about others out there who may be going through the same thing. I want to help you by making you aware. If you have found it impossible to get help, please don’t hesitate to consider that you too may have undiagnosed sleep apnea. It may be the miracle you need.


  52. Rick on April 21st, 2013 1:13 pm

    I am 29 years old I have never had anxiety and or panic attacks until about a year
    Ago I went to the doctor they said oh you have anxiety tried putting me on ssri like 3 different kinds before I finally said enough is enough I felt horrible so a couple weeks ago I went to yet another doctor that suggested sleep apnea could be the cause of me feeling like crap all the time so she’s setting up a sleep study for me hopefully it is the reason I feel super tired all the time and anxious for no reason I personally believe that every anxiety case has an underlying cause I ain’t a doctor just saying that every case of it cannot be a mental issue America is to fast to just put a label on people and frankly I think people are to quick to accept it I have been going through this for about a year and a half now and believe we are finally getting to the bottom of it

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  54. SALVADOR CASTILLO on January 9th, 2014 11:58 am

    I wake up in a cold sweat and adrenaline pumping I feel like I’m in a panic mode heart beating fast what should I do

  55. Irfan Khan on January 21st, 2014 9:44 am

    Recently my mother age 59f is been diagnosed of panic attacks, as this is for the first time we came to know about this.she was hospitalised in icu for further investigation I.e ecg,2D echo, Triop (Blood & urine test) all the reports are normal. As she is suffering from OSA with obesity, diabetes & thyroid. She is using a Auto Cpap. Pls. Suggest us the best medication & further preventive measures Asap.

  56. Stephanie on June 1st, 2014 1:04 am

    My panic attacks start at night time and it always starts up bad after I am done in the bathroom. I start to hunch over like an old person. And I get all stiff and hyperventilate. My last one was really bad my sister told me to sit down on the couch and try to relax and she pushed me back and my legs went up too so I was as stiff as a board. My sister was trying to move my arms and legs to loosen them up but if she let go I just stayed like that. My sister pulled me up from sitting and she told me to walk to the front door and back but instead of turning around I opened the door and went to her car door and said unlock the car so we can go to work. And I also fell asleep a couple mins at the table before I went to the couch and I had no clue that I did that. But I was still breathing fast and shaking but after I was done I felt nausea and tired. I also suffer from epilepsy too. And I am on depression meds too along with my Cpap machine so what would u recommend I do?

  57. David on August 19th, 2014 1:44 am

    Nice to meet all of you. This site brings great hope and joy to me right now! Please read my story and let me know if you are/were going through the same things! My name is David and I am a 25 year old male who before a year and a half ago was perfectly normal and a gym rat. I worked out 6 days a week for 2-3 hours a day and ate extremely healthy. Below are my symptoms and diagnoses thus far.

    Symptoms: Light-headed 24/7, dizzy 24/7, frequent headaches, constant weakness feeling and numbness, eyes always hurt in the sun, easily irriated, constantly woke up in the middle of the night for no apparent reason, and daily diahrrea with IBS symptoms.

    Diagnosis: social anxiety over time, panic disorder with agoraphobia, mild sleep apnea, and restless leg syndrome (RLS)

    Here’s my story. I was at work about a year and a half ago and was joking with a friend. He was telling a story and I just zoned out and had every symptom of a panic attack. This scared me since I had no idea what was going on. I made an appointment and my doctor sent me to cardiology for a stress test and I got to wear a heart rate monitor (to see if it was a heart condition or palpitations). Nothing was found so I went back to my doctor and decided to see a mental health provider. My first visit there, they said I had panic disorder with agoraphobia. I couldn’t deny this since all I could think about was how awful the panic attacks were. It basically consumed most of my time as that is what I focused my mind on. The recommendation was for me to be healthier and work out more…funny as I was in great shape and all of a sudden, I could not stay 10 minutes in the gym. I instantly felt like passing out. I am in the military and my run times kept going down since running seemed impossible. I could only maintain about 10 minutes of running and not even close to a pace I needed. I got on a profile for a while and continued to see the mental health department. After about 6 months of no improvement, I went to an Ear, Nose, and Throat specialist thinking maybe it was an inner ear problem. Nothing was found. Next, was the CT scans and blood work. Only thing found was high liver enzymes (due to my past years of drinking). Fast-forward through about a year of no help and constant anxiety every day, I complained about the terrible sleep I was having. I expressed that I would only get roughly 4-5 hours of sleep maximum and I was tired all the time. My eyes hurt when the sun was out and I zoned out non-stop at work looking at the computer screen. The sleep study showed I have Mild Sleep Apnea and Restless Leg Syndrome.

    I still have to go in for the second sleep study where they will set the limits of CO2 I believe on a CPAP machine and give me one. I am excited to see if I get the same results as many of you have. I would kill for 1 day with minimal anxiety/a restful feeling. I will keep you guys posted once I get my CPAP and hopefully my results are “I’m back to normal again!”

    Until then, take care, thanks for reading, and best of luck! Share your story with me as well please!

  58. Harry on November 8th, 2014 9:03 pm

    I have been using a cpap machine for two months. I feel great. I love that machine. My wife couldn’t take the snoring anymore, so I had to go in for the study. I failed badly Oxygen level peak drop was 77.
    For the last 10-15 years I was becoming a little claustrophobic (airplanes) and have generalized anxiety disorder. Dr has me on 20mg celexa, all good. I began looking on the net for a correlation between anxiety/claustrophobia and sleep apnea. I think I am cured. I will ask the dr. if I can drop the celexa. I know that many have claustrophobic reactions to the face mask, not me. I love that cool air, soothing, good night charlie. male/57years/6ft/210lbs/17neck

  59. Doug on November 22nd, 2014 12:47 pm

    I don’t believe I have really slept more than 4 hrs in 2 years , rare exceptions. About 14 months ago I developed a fear of suffocating or drowning, I had no Idea where this had come from.
    6 Months ago I started to sleep less than 4hrs a day and it was decreasing.
    For the last 2 months or so I have been waking up, no wind feeling like I had held my breath for over a minute. This twice resulted in several 4-7 day periods where I would wake withing seconds of sleeping,in fear, adrenalin surging, having to get up and walk it off.
    Then someone loaned an O2 concentrator to me, I set it at 3-3.5, I live at 7,000ft., I can sleep on the couch easy enough but sleeping in my own bed now is difficult.
    Is it possible that having so many fear events there have caused this and what can I do? No I can’t move to a lower elevation but can sleep 2000 ft lower on the weekends.

  60. Doug on November 22nd, 2014 12:55 pm

    Hello, and in regards to my previous post.

    Sorry didn’t mean to be so short in that post. I have trouble asking for help.

    I am a Vet and am looking into help there but that could be months.

    I Can’t change where we live we own the home which we can’t move but live rent free because we manage the land for the owner. Our retirement plan hehehe.

    Thank you all for your time and patience.

  61. Dan on March 1st, 2015 7:04 pm

    I have been on a Cpap for 10+ years
    Recently I have experienced serious shortness of breath followed very shortly by afib flutter
    I struggle with the machine breath every night and the shortness of breath continues
    Any suggestions
    New test?

  62. Jacques on March 21st, 2015 3:36 pm

    About four months ago I was driving to a job and i felt very faint, lightheaded. So I had to pull over and let one my crew members finish driving which was only about 3 miles. When we reached the destination I could barely stand up let alone do any work,. Very short of breath racing heart rubber like legs. I then asked if he would take me to the er asap, and the whole way there I thought i was going to die. After getting there and them running every test under the sun. They could not find anything wrong. However the doctor asked me if I have anxiety, and me not even knowing what that was really said no, so the subject was dropped and I was released.. About ten days later i was driving again and i started to feel lightheaded and dizzy again so I pulled over and had my wife and father come pick me and my vehicle up. I called my GP and made an appointment, which led to a echeocardiogram, and a MRI, which both came back perfect. And again anxiety was brought up as well as panic attacks. And for weeks I did not understand where this was coming from because I am a very healthy 31 year old man. However I for got to mention that my grandfather, the only grandparent I had mostly my whole life had died on November 10th 2014 and all this started happening on around November 23 rdish. I then began to realize that maybe I really did have anxiety. Last week i did an over night Sleep Test and they have concluded that i do have Sleep apnea and need to wear a mask every night o bed, because of blockage of Oxygen during sleep. Do you think that this could have brought all of this one out of the blue like that? Any insight would be wonderful..

  63. serapio prna on March 26th, 2015 11:27 pm

    Even with my cpap , I find that just as I finally fall asleep I still wake up suffocating at the moment of sleep. Doctors look at me like I’m crazy . Sleep doctors scratch their heads. I’m on my last limb. Please please help me . 469 728 5995. Please

  64. Heather on April 22nd, 2015 11:03 am

    I’m glad I stumbled onto this site. The information has been great.

    My question is about CPAP and medication. I was diagnosed with general anxiety disorder and panic attacks about 5 or 6 years ago and I’m on Zoloft. This year I was diagnosed with pulmonary hypertension which they believe is caused by sleep apnea. I started using a CPAP machine about a week ago and I’ve noticed that I’m experiencing anxiety during the day. Do you think it is possible that with the increased oxygen and decrease of carbon dioxide that I might now be taking too much Zoloft?

  65. Steven Park on April 22nd, 2015 11:09 am


    Sorry to hear. It’s difficult to say without seeing you along with your complete medical history, but sometimes, CPAP can aggravate anxiety, even though it may be helping with sleep. Your doctors are the best people to talk with about this issue. Good luck.

  66. Steven Park on April 22nd, 2015 11:11 am


    People have different responses to CPAP. Many people do much better after a number of trouble shooting steps. Others can’t use it no matter how hard they try. There are other options. Your doctor should be able to help.

  67. Steven Park on April 22nd, 2015 11:12 am


    Thanks for sharing. It’s hard to know, but the only way to know if it’s related is to continue using your CPAP machine for a few more weeks to months and see how it goes. Good luck.

  68. Steven Park on April 22nd, 2015 11:13 am


    It’s important to make sure that your CPAP pressure is accurate. If it’s too high or too low, it won’t work as well.

  69. Mohamed on July 3rd, 2015 4:02 pm

    Sometime in middle of my sleep I wake up after 30 minute usually, with lack of Oxygen and my body kind of paralysed,
    Used to panic a lot before, I even went even to Emergency 4 times before 5 years ago.
    I used to drink I gave up because of reflux and panic attacks.

    Now when l wake up. I have paper bag and breath out in…
    until l feel fine then l drink water.

    If l feel bad, l drink much water and vomit acids or reflux or I poo.
    afterwards I feel fine,

    or l drink water and listen to Quran for meditation. and it helps.

    the Question. do I have breathing problem ? because I snore

  70. Steven Park on July 6th, 2015 7:12 am


    I recommend you see a sleep specialist to make a formal diagnosis.

  71. c garcia on December 7th, 2015 2:45 pm

    I have been using a v-pap for almost 3 years with not many, if any, problems after learning how to sleep with it, Last night i had a serious anxiety and panic attact, After waking up with rapid heart rate,I took off the mask. I decided to sit on the recliner, after dozing off for a few hours I went back to bed to try again but with same results.Any ideas? I have been doing so well with my v-pap BTW,, thanks,,,,V-PAP wearer,,

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