Exploring the link between sleep apnea and atrial fibrillation 

Sleep apnea and atrial fibrillation (AFib) are two common yet potentially serious health conditions that often coexist. Each condition can independently impact a person’s health. However, emerging research suggests a link between sleep apnea and atrial fibrillation. 

Understanding this connection is important for patients and healthcare providers. That way, they can manage each condition effectively. 

Let’s talk more about the mechanisms involved in the relationship between sleep apnea and atrial fibrillation along with the implications for diagnosis and treatment.

Understanding sleep apnea – What is it?

Sleep apnea is characterized by pauses in breathing during sleep. These pauses are known as apneas. They can occur multiple times throughout the night, disrupting normal sleep patterns and leading to fragmented sleep. 

There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA is the more common of the two. It occurs when the muscles in the throat relax excessively, causing a full or partial blockage of the airway. 

In contrast, CSA occurs when the brain fails to properly signal the muscles in the throat responsible for controlling breathing. This dysfunction results in periodic breathing interruptions during sleep. 

Left untreated, sleep apnea can result in serious health complications, including high blood pressure, heart disease, stroke, diabetes, and an increased risk of accidents due to daytime drowsiness. Additionally, it can negatively impact cognitive function and mood stability. 

Sleep apnea’s connection with atrial fibrillation

Atrial fibrillation is a common heart rhythm disorder characterized by irregular and often rapid heartbeats. It can result in poor blood circulation and serious complications, such as stroke. It’s estimated that between 2.7 to 6.1 million Americans live with atrial fibrillation. 

The exact mechanisms linking sleep apnea and atrial fibrillation are still being studied. However, when people with sleep apnea experience pauses in breathing, they go through a cycle of low oxygen levels and then reoxygenation. This cycle can cause the body to react in ways that may lead to atrial fibrillation, such as changes in heart rate and blood pressure.

A recent study published in the Journal of the American Heart Association discovered that low oxygen levels during sleep, known as sleep-related hypoxia, are linked to a higher likelihood of developing atrial fibrillation over time. 

What’s intriguing is that this risk persists even when factors like lung function are taken into account. This indicates that sleep-related hypoxia independently raises the risk of atrial fibrillation, regardless of any underlying lung issues.

The study also revealed some concerning trends. It consisted of over 42,000 participants. And despite participants’ relatively young age (with an average age of 51), 5% were diagnosed with atrial fibrillation within 5 years of their sleep study. Also, for every 10% drop in the average oxygen levels during sleep, the chances of getting atrial fibrillation rose by 30%. These results highlight how crucial it is to deal with sleep apnea and its possible effects on heart health.

Further research is needed to fully understand the relationship between sleep apnea and AFib. However, recognizing and addressing sleep apnea in people with AFib can improve outcomes and reduce complications.

Diagnosis and treatment

Given the potential link between sleep apnea and atrial fibrillation, healthcare providers should consider screening patients with atrial fibrillation for underlying sleep disorders, especially OSA. 

Diagnosis typically involves an overnight sleep study (polysomnography) to assess breathing patterns, oxygen levels, and other sleep parameters. Treatment strategies for people with both sleep apnea and atrial fibrillation may include the following: 

Continuous positive airway pressure (CPAP) therapy

Early detection and intervention for sleep apnea through continuous positive airway pressure (CPAP) therapy may lower the risk of AFib development, especially in people predisposed to heart conditions.

CPAP therapy is a common and effective treatment for sleep apnea. It involves wearing a mask over the nose or mouth during sleep, which delivers a continuous stream of air to keep the airway open and prevent sleep-related hypoxia. 

Lifestyle modifications

Adopting healthy lifestyle habits, such as maintaining a healthy weight, exercising regularly, and avoiding alcohol and tobacco, can improve both sleep apnea and atrial fibrillation. 

People should also consider improving their sleep hygiene. They can do this by…

Establishing a consistent sleep schedule: Establishing a consistent bedtime and wake-up routine, even on weekends, helps keep your body’s internal clock in balance.

Creating a relaxing bedtime routine: Engage in calming activities before bed, such as reading, taking a warm bath, or practicing relaxation techniques like deep breathing or meditation. Also, consider dimming the lights. These activities help signal to the body that it’s time to prepare for sleep. 

Limiting screen time before bed: The blue light emitted by electronic devices like smartphones, tablets, and computers can interfere with your body’s sleep-wake cycle. Try to avoid screens at least an hour before bedtime or use blue light filters.

Limiting naps: While short naps can be beneficial, especially for reducing daytime fatigue, long or irregular naps can interfere with nighttime sleep.

Medications

In some cases, doctors may prescribe medications to manage symptoms of atrial fibrillation or address underlying cardiovascular risk factors. These medications include digoxin, metoprolol, verapamil, and diltiazem.

The relationship between sleep apnea and atrial fibrillation is complex and multifaceted. However, by addressing sleep apnea through appropriate diagnostic testing and treatment, healthcare providers can improve outcomes and reduce the risk of complications in patients with atrial fibrillation. 

Furthermore, it’s important to make people aware of this connection so they can detect and address it early. By working together—patients, healthcare providers, and researchers—we can learn more about these conditions and provide better care for those affected.

Dr. Meghna Dassani has practiced dentistry for over two decades and is passionate about the role dentists play in whole-body health. You can learn more at her website: MeghnaDassani.com.