Half the patients with AFIB also have sleep apnea.
Patients with sleep apnea have 4 times the risk of developing atrial fibrillation.
How does sleep apnea contribute to AFIB? Potential mechanisms:
- Changes in intrathoracic pressure during apneic episodes leads to left atrial stretch.
- Intermittent periods of hypoxemia (low oxygen) and hypercapnia (high carbon dioxide) related to apnea lead to atrial remodeling with regions of fibrosis (scarring).
- Increased adrenaline release during apneic episodes.
- Increased vagal tone during apneic episodes.
While treating sleep apnea will not eliminate your AFIB, it will make management of AFIB easier. Post ablation for AFIB, patients with obstructive sleep apnea have 25% to 31% increased risk for AF recurrence in comparison with patients with no sleep apnea.
Whether the patient has ablation for AFIB – pulmonary vein isolation (PVI) or not, treating sleep apnea leads to better outcomes.
A study in JACC showed that if you have sleep apnea and don’t treat it, you might as well not have an ablation for AFIB.
A well written review article on sleep apnea and AFIB :
You didn’t recommend the tennis ball on the back of the night shirt. I have been doing it since you suggested it to me, and it has eliminated my sleep apnea. Now I use two tennis balls in a pocket sewn on the back of my pajama top, since I had gotten comfortable enough with one tennis ball that my wife would sometimes find me snoring on my back in spite of it. Two tennis balls seems to have fixed that. I wake up very rested and stay on my side all night.