Sunday, November 24, 2013

Sleep Apnea and Afib


What Is Sleep Apnea?

In obstructive sleep apnea, your airway collapses or is blocked during sleep. When you try to breathe, any air that squeezes past the blockage can cause loud snoring. It is however, much more than simply snoring, as it can have serious detrimental effects to your health.


Sleep apnea and Atrial fibrillation
Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.





Sleep Apnea and Atrial Fibrillation


Sleep Apnea is associated with an increased risk of many cardiovascular conditions. It increases the stress in your heart. It is associated with increased risk of hypertension, congestive heart failure, heart attacks, strokes, diabetes, obesity and atrial fibrillation

It is well known that there is a greater risk of atrial fibrillation among those with obstructive sleep apnea. Sleep Apnea causes progressive dilatation of the atria and makes one more prone to afib and afib recurrences after treatment. 
Afib patients with untreated sleep apnea are more likely to revert back into afib after electrical cardioversion and even after an afib ablation than other afib patients without sleep apnea.

Treatment
There is treatment for sleep apnea. Patients need first be screened and then have a formal sleep study if indicated. For those diagnosed with sleep apnea, weight loss and some lifestyle modifications can help. Most patients are treated with CPAP.



What Is CPAP?
CPAP, or continuous positive airway pressure, is a treatment that uses mild air pressure to keep the airways open. 

CPAP treatment involves a CPAP machine, which has three main parts:

  1. A mask or other device that fits over your nose or your nose and mouth. Straps keep the mask in place while you're wearing it.
  2. A tube that connects the mask to the machine's motor.
  3. A motor that blows air into the tube.


CPAP has many benefits. It can:
  1. Keep your airway open while you sleep
  2. Correct snoring so others in your household can sleep
  3. Improve your quality of sleep
  4. Relieve sleep apnea symptoms, such as excessive daytime sleepiness
  5. Decrease or prevent high blood pressure

Many people who use CPAP report feeling better once they begin treatment. They feel more attentive and better able to work during the day. They also report fewer complaints from bed partners about snoring and sleep disruption.



If you have sleep apnea, treatment is of utmost importance if you want to have your afib under control. 

Do you have both atrial fibrillation and sleep apnea? Please post your comments.



Jose Osorio, MD
Cardiac Electrophysiologist

St Vincent's Hospital
Birmingham, AL

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