Sleep Apnea vs. Insomnia: What Is the Difference?

A woman lying awake in bed, experiencing insomnia. The same woman is snoring and gasping for air due to sleep apnea.

Written by: Gabrielle Talan

Gabrielle, a former insomniac turned sleep writer, brings over a decade of content expertise to her work. For the past 3 years, she's focused exclusively on sleep topics – a happy choice that helps give her the deep and restful sleep she craves.

Have you been struggling to drift off (despite counting an overwhelming number of sheep) and stay asleep? Has your partner shared the disturbing news that you've been snoring loudly and gasping for air in your sleep? You may have sleep apnea or insomnia, both of which are common sleep disorders.


Understanding sleep apnea and insomnia is key to effective treatment. This blog post aims to define these sleep disorders, highlight their differences and similarities, explore the link between them, and outline ways to manage and treat insomnia and sleep apnea to help you regain restful sleep.

Key Takeaways

  • Sleep apnea and insomnia are different sleep disorders, but they are often connected. Left untreated, these disorders can impact your sleep quality, daily life and overall health.

  • Both disorders have similar symptoms, including daytime fatigue, cognitive difficulties and disrupted sleep.

  • Insomnia and sleep apnea require proper diagnosis and tailored treatments, like CPAP therapy or lifestyle changes for the latter, and CBT-I and good sleep hygiene for the former.

Table of Contents

What Is Sleep Apnea?

A woman sleeping in bed, snoring loudly due to sleep apnea.

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep, leading to a drop in oxygen levels. These pauses are referred to as "apneas," where you stop breathing completely for at least 10 seconds, or "hypopneas," where there's a partial cessation of airflow lasting at least 10 seconds.


The symptoms of sleep apnea include loud snoring and choking or gasping for air during sleep.


There are three types of sleep apnea:


  • Obstructive sleep apnea syndrome (OSA) is a common form of sleep apnea characterized by the collapse of soft tissues in the throat, obstructing the airways and causing pauses in breathing.

  • Central sleep apnea occurs when breathing is paused because the brain fails to correctly signal the muscles that control breathing.

  • Complex Sleep Apnea Syndrome (CompSAS), also known as treatment-emergent sleep apnea, is often temporary. It's when a CPAP used to treat OSA removes the obstructive instances, which are then replaced by central sleep apnea.


Here are the risk factors for sleep apnea:


  • The most common one is obesity. Fat deposits around the neck can obstruct the airways.

  • Having a wider neck circumference can also predispose you to sleep apnea.

  • Sleep apnea is more common in older adults and occurs more often in men than women. Genetics can also play a role; if you have a family history of sleep apnea, your risk is higher.

  • Drinking alcohol and taking sedatives can also increase your risk of sleep apnea because they relax the muscles in your throat. Smokers are also more likely to develop sleep apnea than non-smokers.

  • If you can't breathe through your nose due to congestion from allergies or an anatomical problem, you're also more likely to develop sleep apnea.

  • Medical conditions, such as type 2 diabetes and high blood pressure, are also risk factors.

What Is Insomnia?

A woman lying in bed, unable to sleep due to insomnia.

Insomnia is a sleep disorder marked by trouble falling asleep, staying asleep or waking up often at night. We aren't talking about occasional poor sleep here. Insomnia can last for days or even months, depending on the type.


There are two types of insomnia:


  • Acute insomnia is short-term and is defined as trouble sleeping lasting for a few days up to less than 3 months. It's usually caused by stress, a traumatic event, disrupted sleep due to jet lag or shift work, environmental changes and poor sleep hygiene.

  • Chronic insomnia occurs at least three times a week for 3 months or more. Apart from short-term sleep troubles, this persistent insomnia is triggered by mental health issues, medical conditions or certain medications.

What Symptoms Do Sleep Apnea and Insomnia Have in Common?

While they are distinct sleep disorders, sleep apnea and insomnia share some symptoms:


  • Both disorders result in excessive daytime sleepiness and fatigue, even when you think you've had enough sleep.

  • Both can cause cognitive difficulties, such as trouble concentrating and focusing, and memory lapses.

  • They can also cause you to be irritable, anxious and depressed. You might also experience mood swings.

  • Both cause sleep disruptions.

  • Both disorders prevent you from getting restorative sleep, which leaves the brain sleep-deprived. This state leads to slower reaction times and making frequent mistakes, both of which are especially dangerous when driving or operating heavy machinery.

  • You might wake up with a headache.

  • You might dread or fear sleep, which is also known as sleep anxiety, which makes sleeping even more of a struggle.

  • Both can negatively impact your day-to-day life and sleep quality.

What Are the Key Differences Between Sleep Apnea and Insomnia?

The key differences between sleep apnea and insomnia lie in their core mechanisms, main causes and symptoms.

Definitions

  • Sleep apnea is a sleep-related breathing disorder that's characterized by recurring pauses in breathing during sleep.

  • Insomnia's core mechanism is trouble with sleep, characterized by difficulty falling asleep or staying asleep. It's a problem of sleep maintenance and initiation.

Main Causes

  • Sleep apnea primarily results from airway obstruction caused by physical blockages and anatomical abnormalities. Breathing disruptions can also result from a disconnect between the brain and the breathing muscles.

  • Psychological factors, including stress, anxiety and depression, cause insomnia. Irregular sleep schedules, poor sleep hygiene and certain medications are other contributing factors. Environmental factors such as noise and light can lead to insomnia, but don’t cause sleep apnea.

Key Symptoms

  • Sleep apnea is characterized by loud snoring, gasping for air or choking, waking up short of breath and waking up with a dry mouth. Some people aren't even aware they have breathing lapses.

  • Insomnia's hallmark symptoms include lying in bed unable to sleep and being aware of it, having difficulty falling back asleep and waking up too early in the morning.

How Are Sleep Apnea and Insomnia Connected?

Sleep apnea and insomnia have a complicated connection, which experts refer to as "bidirectional."


A study published in Sleep Medicine Reviews found that an estimated 30% to 50% of people with OSA experienced symptoms of clinical insomnia, while 30% to 40% of people with chronic insomnia met the diagnostic criteria for OSA.(1)


Sleep apnea can give rise to sleep troubles that mirror the key symptoms of insomnia, which are difficulty falling asleep and staying asleep. Meanwhile, insomnia can worsen sleep apnea symptoms.


Some people with OSA often complain of restless sleep (common in insomnia) due to recurring breathing pauses—meanwhile, some who have insomnia and OSA experience more frequent awakenings.


They also share risk factors, such as obesity, age and certain medical conditions. Older adults are more prone to developing both disorders. People who have medical conditions, like chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD), are also at risk for both sleep apnea and insomnia.

Can Sleep Apnea Cause Insomnia and Vice Versa?

Yes, sleep apnea can cause insomnia. The immediate reason is that people with sleep apnea might experience insomnia-like symptoms due to breathing pauses that cause awakenings and make it hard to fall back asleep. These awakenings can cause sleep fragmentation, resulting in less time spent in the deeper, more restorative sleep stages, which can lead to the development of insomnia over time.


People with sleep apnea can also experience stress and anxiety due to poor sleep quality and discomfort when using a continuous positive airway pressure (CPAP) machine, leading to the development of insomnia.


While insomnia can't physically cause sleep apnea, it can worsen the disorder or make it more obvious.


Chronic insomnia is associated with increased stress and anxiety, which can exacerbate sleep apnea symptoms. Some sedatives used to treat chronic insomnia can also cause the muscles in the throat to relax, triggering sleep apnea episodes or uncovering a previously undiagnosed condition.

Can You Have Sleep Apnea and Insomnia at the Same Time?

Yes, you can have sleep apnea and insomnia at the same time. It's known as comorbid insomnia and sleep apnea (COMISA), and it has a worldwide prevalence of 18% to 42%, according to a study published in Chest Journal.(2)


The combination can result in more serious challenges with sleep, daily life, and overall health than either condition alone. People with COMISA are also at higher risk for metabolic and heart diseases and mental health conditions.


COMISA is difficult to diagnose because current tests aren't perfect, according to research published in Seminars in Respiratory and Critical Care Medicine.(3) It's a complicated condition that needs personalized treatment.

How to Treat Sleep Apnea and Insomnia

There are several treatments available for sleep apnea and insomnia. The gold standard for diagnosing both disorders is known as a sleep study (polysomnogram), which simultaneously tracks breathing patterns and brain waves.


Let's explore the treatments for sleep apnea:


  • If your sleep apnea is caused by obesity, losing weight will help.

  • You'll need to avoid alcohol before bedtime, as well as quit smoking.

  • You might need to switch to the best sleeping position for breathing problems: on your side.

  • If you have OSA, you might need to use a CPAP machine, which delivers a continuous and pressurized stream of air to help keep your airways open. A CPAP is sometimes also used to treat COMISA.

  • You might need to use custom-made oral appliances to reposition your jaw or tongue, such as a mandibular advancement device (MAD) or a tongue-retaining device (TRD).

  • Surgery is another option if other treatments fail, including removing excess tissue or correcting structural problems.

  • Servo-ventilation is similar to a CPAP except it monitors your breathing patterns in real time and adjusts the pressure automatically.

  • Addressing underlying medical conditions that might be causing sleep apnea, such as hypothyroidism or nasal congestion, can also help.


Here are the most common insomnia treatments:


  • Cognitive behavioral therapy for insomnia (CBT-I) involves changing the behaviors and thoughts that might worsen insomnia, sleep restriction and patient education on relaxation techniques.

  • Establishing good sleep hygiene habits, such as maintaining a consistent sleep schedule, using a sleep mask or earplugs to create a dark, quiet sleep environment, and avoiding caffeine and heavy meals too close to bedtime.

  • Stress management improves sleep by reducing anxiety through techniques like progressive muscle relaxation, deep breathing exercises and meditation.

  • Prescription medications like sedative-hypnotics, melatonin receptor agonists and certain antidepressants can help with short-term sleeplessness.

  • Treating underlying health problems, such as mental health disorders (like post-traumatic stress disorder), chronic pain and neurological disorders (like Parkinson's disease).

Conclusion

Understanding the differences and similarities between sleep apnea and insomnia is super important for effective management and treatment. While both disorders disrupt sleep and share symptoms, their underlying causes and treatment methods differ.


Do you have sleep apnea or insomnia? Share your experiences and management tips with other readers by commenting below.

Frequently Asked Questions About Sleep Apnea and Insomnia

How Can I Tell if I Have Sleep Apnea or Insomnia?

You can tell if you have sleep apnea or insomnia by the symptoms you are experiencing. People with sleep apnea experience loud and frequent snoring. They might also choke or gasp for air while sleeping or wake up with a dry mouth and a headache.


Meanwhile, people with insomnia have trouble falling asleep and staying asleep, even when they are tired. They might wake up too early and be unable to fall back asleep.


Both sleep disorders cause excessive daytime sleepiness, fatigue and cognitive difficulties.

Is a Morning Headache More Common With Sleep Apnea or Insomnia?

A morning headache is more common in people with sleep apnea, though people with insomnia can experience it as well. Recurring breathing pauses during sleep can cause a drop in oxygen levels, which might lead to a morning headache. It can also lead to a buildup of carbon dioxide, which causes blood vessels in the brain to dilate, making your head throb.

Is Insomnia Genetic? Is Sleep Apnea Genetic?

Yes, insomnia and sleep apnea can both be genetic.


Insomnia can be genetic, as the way the brain responds to sleep and regulates stress can run in families. However, while this can predispose you to the condition, it's usually life stressors that lead to the development of insomnia.


Sleep apnea also has a genetic component, in which fat distribution, airway shape and size, and muscle tone might predispose you to the disorder.

If I Have Both, Which Do I Treat First, Sleep Apnea or Insomnia?

If you have both, sleep apnea is traditionally the first to be treated. That's because it can pose immediate health risks due to the drop in oxygen levels caused by breathing pauses. Also, the use of a CPAP machine to treat obstructive sleep apnea might improve your overall sleep quality, reducing insomnia symptoms.


However, modern medicine is changing the way comorbid insomnia and sleep apnea are treated. Some doctors might require either treating insomnia first with CBT-I or alongside sleep apnea treatment. Treating insomnia first might help with CPAP machine use, which can initially be challenging and uncomfortable.

Will Using a CPAP Fix My Insomnia if Apnea Is Its Cause?

If your insomnia is caused by sleep apnea, using a CPAP machine can help ease insomnia symptoms in most cases. The machine works by keeping your airway open and reducing breathing pauses, which fragment sleep. Reducing sleep fragmentation makes it easier to fall asleep and stay asleep.


Keep in mind that if your insomnia doesn't improve with CPAP machine use, you might need to be treated for it separately with CBT-I or other forms of treatment.

Sources:  

(1) "Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA).” Sleep Medicine Reviews, www.sciencedirect.com/science/article/abs/pii/S1087079221001040. Accessed 06 February 2026.

(2) “Sleep Apnea and Insomnia” Chest Journal, pmc.ncbi.nlm.nih.gov/articles/PMC8129729/. Accessed 06 February 2026.

(3) “Comorbid Insomnia and Sleep Apnea: From Research to Clinical Practice.” Seminars in Respiratory and Critical Care Medicine, pubmed.ncbi.nlm.nih.gov/40258387/. Accessed 06 February 2026.


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