While waking up groggy and dazed after a full night of sleep are some of the most recognizable symptoms of sleep apnea, there are dangerous effects of sleep-disordered breathing that occur inside the body, too. Sleep apnea and AFIB (atrial fibrillation) have been connected for years. Here’s the latest research into these connected conditions and what it means for you.
What’s the sleep apnea and AFIB connection?
Atrial fibrillation is a serious heart condition that affects an estimated two and half million people in the U.S. While this is a high incidence, consider this statistic: half of patients with AFIB also have sleep apnea. And on the flip side, the estimated 25 million patients diagnosed with sleep apnea are four times as likely to develop AFIB. The sleep apnea and AFIB correlation is so strong that some researchers refer to it as a dual epidemic.
But what is AFIB, and what’s the sleep apnea and AFIB correlation?
AFIB occurs when improper electrical signals in the atria don’t message the heart to contract properly. Instead, the upper heart chambers just shake slightly, allowing blood to pool instead of moving through the heart. This pooled blood can eventually break free and enter the bloodstream, causing a stroke. AFIB sufferers have five times the risk of stroke as those with regular heartbeats.
One of the ways sleep apnea may be connected to AFIB is through what causes them. Obesity and cardiovascular disease are risk factors for both conditions. The presence of each risk factor increases the chances of developing these conditions concurrently.
Further, the nightly, consistent oxygen deprivation that occurs during apneas (pauses in breath) places significant stress on the walls of the heart. This can lead to the development of arrhythmia. Over time, the body remembers this stress and may continue to react even during the day. Systemic change can occur in the heart and brain as AFIB develops and sleep apnea persists.
Sleep apnea and AFIB research
As the incidence of sleep apnea and arrhythmia rises, research on both conditions increase. Much of the research confirms studies that have come before. Now, though, these focus on better screening tools and treatment options.
Here’s what we know.
Sleep apnea increases arrhythmias
It is not entirely unusual for your heart to skip a beat. However, patients with AFIB suffer from more than just a flutter every now and then.
And it turns out that sleep apnea actually increases the irregular heartbeat that can lead to blood clots and stroke. The more severe the sleep apnea, the higher the number of arrhythmias that may occur throughout the day.
Lack of sleep is a powerful trigger of AFIB
An estimated 85% of sleep apnea cases are undiagnosed. Some researchers are starting to look at patients whose lack of sleep triggers their AFIB and recommending formal sleep studies to rule out (or diagnose) sleep apnea.
Even with a deeper understanding of the sleep apnea and AFIB correlation, the issue of communication between sleep clinic and cardiologist still remains. Often AFIB is diagnosed by one doctor, and sleep apnea by another, with no connection between the two. Working with a general practitioner who monitors every aspect of your health can help you bridge this divide.
Irregular heartbeat incidence increasing
An article published by The BMJ the day before Valentine’s Day in 2019 struggled with the debate about increased screening for irregular heartbeat. They noted that increased screening does not necessarily improve outcomes. This may be due to false positives that lead to overtreatment.
However, when considered with other symptoms (e.g., poor sleep or diagnosed sleep apnea), screening can save lives. Patients taking anti-coagulants for AFIB to decrease their chance of stroke saw their risk cut in half in just 18 months.
Young athletes with sleep apnea at increased risk of sudden cardiac death
We have all heard tragic stories of young athletes in their prime cut down by a sudden heart attack with no signs. But where there really no signs?
A study from the European Lung Foundation revealed that the young rugby players in their study had a higher incidence of sleep apnea than middle-aged men. They also had lower levels of blood oxygen and higher pulse rates at night – both risk factors for AFIB and sudden cardiac death.
Yoshitaka Iso, a cardiologist and Associate Professor at Showa University Research Institute for Sport and Exercise Sciences in Yokohama, Japan noted that our assumptions about the health of young athletes are not always true, noting:
“We tend to assume that young, competitive athletes will not experience conditions like [sleep apnea], which [is] more common in people with a higher BMI and inactive lifestyles, but more research is needed to determine what may be contributing to sudden cardiac death in athletes, and [sleep apnea] is a good candidate for this as it can affect the heart’s normal functions.”
These studies all point to how much more there is to learn.
Does treating sleep apnea help with AFIB?
Even with the mysteries that remain, one thing is very clear: the relationship between sleep apnea and AFIB is bidirectional – that is, either one increases the risk of the other.
Treating one condition can often help manage (and sometimes even eliminate) the other.
The American College of Cardiology found in 2015 that treating sleep apnea results in fewer atrial fibrillations at night. In fact, using a CPAP machine reduced atrial fibrillations by 42%, regardless of what treatment was being offered for AFIB.
Does this mean that simply treating sleep apnea is enough to cure AFIB? The sleep apnea and AFIB connection do not go quite that far, but taking steps to treat one can have a positive impact on the other.
AZ Dentist is your sleep apnea dentist in Arizona. We work with primary care physicians and specialists to treat all kinds of conditions related to sleep apnea. If you have sleep apnea along with AFIB and want to learn more about your treatment options, give us a call today.