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Is Sleep Apnea a Risk Factor for AFib?

November 28, 2023

A mature man with sleep apnea is at greater risk for AFib.

Snoring can make it challenging for you (and your loved ones) to get a good night’s sleep. Sometimes, this snoring is associated with sleep apnea. Sleep apnea is a common condition where the air passage in the back of the throat closes during sleep. This blockage can disrupt your sleep and lead to stress on the body overnight.

Meanwhile, atrial fibrillation, or AFib, is a common cardiac problem where the heartbeat has an abnormal rhythm. AFib is a serious condition that can be a strong risk factor for stroke and other problems on its own, along with symptoms such as palpitations and shortness of breath. Underlying heart disease, family history and alcohol consumption are some of the factors that make it worse. And in the last few decades, a growing number of studies have shown that sleep apnea is often a risk factor for developing AFib.

Matthew Epstein, MD, a sleep medicine specialist with Atlantic Health System, shares more on the connection between sleep apnea and AFib and steps you can take to sleep soundly with your heart in check.

Linking Sleep Apnea and AFib

Recent studies suggest that more than half of people with AFib also have sleep apnea. And patients with sleep apnea have an increased risk of developing AFib compared to patients without sleep apnea. That’s because sleep apnea leads to stress on the heart. This can result in harmful consequences that affect the heart’s ability to pump blood throughout your body.

“With sleep apnea, instead of sleep being a restful time, it becomes a stressor on your body and can lead to a lot of health risks, including cardiovascular and metabolic problems,” says Dr. Epstein. “Sleep apnea can cause a drop in your oxygen and rise in carbon dioxide, as well as other acute stress affecting the heart when you’re trying to pull air in, but your throat is blocked.”

While AFib is diagnosed with an electrocardiogram (EKG), sleep apnea is identified with an overnight sleep study.

“It’s important that patients have a sleep study to diagnose or detect sleep apnea,” says Dr. Epstein. “Sleep studies help answer the question whether sleep apnea might be the underlying cause of AFib.”

Treating Sleep Apnea and AFib

Fortunately, treating sleep apnea may reduce the occurrence of AFib. Studies have also shown that when patients had AFib and underlying sleep apnea, treating apnea first may improve their outcomes in treating AFib. AFib treatment without addressing the underlying sleep apnea is often less successful.

Sleep apnea treatments can include CPAP (continuous positive airway pressure) machines, dental appliances and surgery. Several clinical trials of medical treatments are also currently underway. Other factors that make apnea worse include weight gain, alcohol and sleeping pills, so controlling these causes can help improve sleep apnea.

Once sleep apnea is under control, it becomes easier to treat AFib more effectively. Treatment may include:

  • Ablation: A procedure that uses heat, cold or electricity to scar the special areas within the heart and return it to its normal rhythm
  • Antiarrhythmic medication: Medicine that helps the heart pump at a normal rhythm
  • Cardioversion: Electrical therapy that resets the heart’s rhythm
  • Modifying risk factors: Like maintaining a healthy weight and lowering blood pressure

For patients with sleep apnea, AFib treatment may also include adjusting lifestyle factors, including avoiding alcohol consumption. Early treatment of AFib seems to work better for patients.

“Whatever treatment is implemented for AFib may not work as effectively if there is still untreated apnea in the background causing ongoing irritation to your heart,” says Dr. Epstein. “For patients whose sleep apnea is causing AFib, if the apnea is found and treated early, the AFib may never come back.”

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