Can Cpap Treatment Help Afib
Continuous positive airway pressure treatment is one of the most common ways doctors treat sleep apnea. But if sleep apnea is connected to AFib, can CPAP therapy treat both at the same time?
Well, not exactly. CPAP therapy does not directly treat or prevent AFib. But, as we described in the previous two sections, sleep apnea can interfere with AFib treatment and prevention methods.
So, sleep apnea treatment methods like CPAP therapy can potentially increase efforts against AFib. For people at risk of developing AFib, this might include antiarrhythmic prevention treatment.
Researchers have linked sleep apnea and AFib in a variety of ways. First, they consider the effects of sleep quality itself on the development of AFib. Sleep apnea results in sleep disturbances, potentially leading to a higher risk of developing AFib.
Then theres the possibility that sleep apnea symptoms like hypoxia and inflammation might cause AFib.
Finally, theres the effect of sleep apnea on AFib care. Multiple studies have connected continuous airflow with successful AFib prevention efforts and treatment methods. When your sleep apnea is under control, you might have better chances of handling AFib.
Does Afib Cause Insomnia
In 2018, a study from the Internal Medicine Journal found a significant link between atrial fibrillation and insomnia. They also found a link between atrial fibrillation and frequent nocturnal awakening.
This study illuminates a connection between AFib and sleep quality that might be somewhat independent of the link between AFib and sleep apnea. This is relevant for people who have sleep problems but not sleep apnea. Based on these findings, people in that category might want to get checked for atrial fibrillation even though they may not have sleep apnea.
What Is The Correlation Between Atrial Fibrillation And Sleep Apnea
It is estimated that 50% of people with atrial fibrillation have sleep apnea. Sleep apnea causes intermittent periods of low oxygen and fluctuations in blood pressure throughout the night. These changes put extra pressure on the heart and cause the body to release stress hormones. The stress hormones increase overall inflammation, damage blood vessels and upsets the balance and regulation of other hormones. Over time, the nightly struggle to breathe leads to structural changes within the heart and irritation of the hearts electrical conduction system. Researchers think it is these structural changes coupled with the irritated electrical conduction system that are the link between sleep apnea and Afib.
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What Foods Trigger Atrial Fibrillation
The last trigger group is certain foods and beverages. This is not a specific trigger for everyone, but there are plenty of patients in mind that know that, for example, a fried food meal is going to trigger episodes of atrial fibrillation, or a particularly heavy meal is going to trigger an episode of AFib, or spicy food. Some of this goes back to being a detective about your diet. For example, knowing what you may have eaten 24 hours prior to when you get an AFib episode may help you figure out what food you particularly need to avoid. If you’re looking for diet tips, look at my other for diet tips on atrial fibrillation.
Effect Of Treating Af On Sdb
A single overnight treatment with overdrive ventricular pacing was able to reduce the number of central apnea events in patients with permanent AF and HF . A reduction in central respiratory events was also documented in a study of 138 patients with AF or atrial flutter after restoration of sinus rhythm with electrical cardioversion the number of patients with CSA before and immediately after cardioversion was 53 and 23, respectively . In patients with drug-refractory persistent AF, treatment with radiofrequency catheter ablation was associated with a significant reduction in the AHI, and there was a significant correlation between the outcome of the ablation procedure and the percent change in AHI .
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Can Sleep Apnea Cause Atrial Fibrillation
Atrial fibrillation is a serious heart condition impacting approximately six million Americans. It is caused by a quivering or irregular heartbeat which prevents the upper chambers of the heart, called the atria, from contracting properly. This causes blood to pool in the atria, increasing your risk of a clot. If these blood clots enter your bloodstream, they can trigger a stroke. In fact, individuals with atrial fibrillation are five times more likely to have a stroke than people who dont suffer from this heart condition.
While there are a variety of potential causes of Afib, there is growing evidence linking obstructive sleep apnea as a significant risk factor for the condition. In addition, this research finds that addressing your sleep apnea in conjunction with Afib treatment can lead to better outcomes and a reduced risk that atrial fibrillation will recur in the future.
Common Triggers For Afib
What can cause an individual episode of atrial fibrillation? In a previous post, I discussed what are the most common causes of the long-term condition of atrial fibrillation, but in this segment, I will discuss things that can actually exacerbate or trigger an episode of atrial fibrillation.
Now, some of these triggers don’t apply to everyone. Figuring out which triggers affect your atrial fibrillation means you needing to be a detective about your own atrial fibrillation to know what more commonly triggers your atrial fibrillation, so you know better what to avoid.
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The Association Of Af And Osa
Most observational studies, although not all,35,36 have suggested that cardiac arrhythmias are more frequent in OSA patients than in unaffected individuals3740 and that the frequency of arrhythmias increases with the severity of apnea.3840 One such study by Hoffstein et al38 prospectively followed 458 subjects undergoing polysomnography for evidence of cardiac arrhythmias and reported a 58% prevalence for those with OSA vs 42% in the controls . They also demonstrated that the frequency of cardiac arrhythmias increased with the AHI, with 70% of patients with AHI 40 displaying arrhythmias vs 42% with an AHI 10 .
The Bottom Line For Afib Patients
As I mentioned earlier, anywhere from 40-50 percent of AFib patients have sleep apnea. And as I also mentioned, untreated sleep apnea can make your AFib treatments less effective.
For these reasons alone, having a sleep study done is a no-brainer if you have atrial fibrillation! Don’t wait any longer. If nothing else, having one done and finding out you don’t have it will give you peace of mind.
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How Do You Screen For And Diagnose Sleep Apnea
Screening for sleep apnea includes assessing and identifying known risk factors for and complications of sleep apnea like AFib, obesity, high blood pressure, heart failure, diabetes and stroke. The process of screening for obstructive sleep apnea commonly includes a validated sleep apnea screening tool, such as the STOP-BANG questionnaire and/or the Epworth Sleepiness scale. These assessments are not a substitute for sleep testing but give useful clinical information regarding how likely someone is to have obstructive sleep apnea and the severity of a persons sleep apnea symptoms. See below for the STOP-BANG questionnaire. A score of less than 3 indicates low risk for OSA, 3-4 suggests intermediate risk and 5-8 high risk.
|STOP-BANG Questionnaire: One Point Awarded for Each Question Answered With YesSnoring: Do you snore loudly ?Tired: Do you often feel tired, fatigued, or sleepy during daytime?Observed: Has anyone observed you stop breathing during your sleep?Blood Pressure: Do you have or are you being treated for high blood pressure?BMI: BMI more than 35 kg/m2?Age over 50 years old?Neck circumference greater than 40 cm ?Gender male? Modified from Chung F, Yegneswaran B, Liao P, et al. STOP Questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 2008:108 812-21.|
Instability Of Autonomic Tone/sympathetic Activation
Nocturnal apneas occur repeatedly during sleep in OSA patients and are accompanied by chemoreceptor induced sympathetic activation and/or decreased parasympathetic tone that has been demonstrated through impaired vagal input, diminished baroreflex sensitivity, and impairment of the parasympathetic components of heart rate variability6 Decreased heart rate variability and increased blood pressure variability are known to elevate cardiovascular risk including heart failure, myocardial infarction, arrhythmic complications, and death, and have been associated with OSA in several studies.13,14
The mechanism by which this heightened sympathetic activity occurs has yet to be elucidated8 but has also been demonstrated as peripheral vasoconstriction resulting in markedly elevated systemic blood pressures.15,16 A strong association between OSA and hypertension has been reported extensively,17,18 and the association between hypertension and AF is also well recognized.19,20 While entirely speculative, one possible link between OSA and AF could be left atrial enlargement that occurs as a result of elevated left ventricular pressures from hypertension induced diastolic dysfunction.6,21 Diastolic dysfunction has been shown to be a powerful predictor of left atrium size22 and AF,23 and several studies have demonstrated the independent association of diastolic dysfunction and OSA.2426
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Central Sleep Apnea And Afib
A study from October of 2020 provides new evidence for a causal link between Central Sleep Apnea and atrial fibrillation. The authors of the study point to symptoms of CSA as potential causes of AFib. These include hypoxia and irregular levels of carbon dioxide.
The study also suggests that the treatment of CSA can lower the rates of atrial fibrillation development in people who are at risk. When patients show signs that they might develop AFib, they often go through preventative treatment.
AFib prevention can happen in the form of pharmaceuticals or catheters. According to this study, CSA can affect the success of both forms of treatment.
The idea here is that if those with AFib get CSA treatment first, then they might have a better shot at AFib prevention.
Symptoms Of Sleep Apnea
Snoring, especially loud persistent snoring is a very common symptom. Pauses in your breathing or gasping for air in your sleep are other classic symptoms.
Unfortunately, unless you sleep with a partner and they witness these symptoms, they may go undetected.
Other common symptoms of sleep apnea include:
- Waking up with headaches
- Waking up just as tired as you were when you went to bed
- Inability to concentrate or focus
- Difficulty staying awake during the day
- Excessive daytime sleepiness
You’ve probably heard sleep apnea is a condition that primarily affects overweight people. While it’s true being overweight or obese is a primary risk factor, people who are at an ideal weight can be at risk as well, so don’t let your weight be your gauge.
Instead, watch for any of the symptoms outlined above. And if you have atrial fibrillation, you’ll especially want to be mindful of the possibility of sleep apnea as you’ll see in a minute.
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How Do You Treat Sleep Apnea
Continuous positive airway pressure therapy is the most common first line treatment for sleep apnea. Effective CPAP therapy decreases respiratory events during sleep. This leads to improved sleep quality, decreased daytime sleepiness and improved quality of life.
Research has shown that CPAP significantly reduces the recurrence of atrial fibrillation. It is thought that the reduced physiologic strain of repeated intermittent apneas and hypopneas can help decrease the risk of the long-term complications of untreated sleep apnea like AFib, heart failure, heart disease and stroke. Current research is ongoing to help quantify the effect of CPAP on these diseases.
If a persons sleep apnea is not adequately treated with CPAP, there are other, more sophisticated, positive airway pressure devices available. The ideal goal is to attain and maintain an AHI of less than 5 as this means that the sleep apnea is well treated.
Physical discomfort associated with CPAP use is one of the key barriers to use. Luckily, there are numerous mask design options available. Proper mask fit makes CPAP therapy more comfortable and effective. For some people, it can take time to get used to sleeping with a mask on. However, with some patience and persistence most people adjust to CPAP and many appreciate feeling rested after a good nights sleep.
Does Sleep Apnea Cause Atrial Fibrillation
Kathy never seemed to get a good night of sleep. Her husband, John, told me she snores like a train and then stops breathing. After a pause, she gasps for air, and then goes back to sleep.
Does this sound like someone you know? If so, they likely have a condition called sleep apnea. Not only does sleep apnea make people feel tired all of the time but it also puts them at high risk for high blood pressure, heart failure, sudden cardiac arrest, and atrial fibrillation.
In this article, I will discuss why sleep apnea is so dangerous and treatment options to avoid this risk.
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Should People With Afib Be Screened For Sleep Apnea
Treatment of atrial fibrillation should include assessment for sleep apnea because untreated sleep apnea decreases the efficacy of AFib treatment with either medication or catheter ablation. Patients with atrial fibrillation and obstructive sleep apnea have about a 30% increased risk of AFib recurrence after catheter ablation when compared to patients without sleep apnea. The American College of Cardiology guideline on atrial fibrillation that recommends assessment and treatment of underlying sleep apnea in patients with AFib. A recent study investigated the prevalence of undiagnosed sleep apnea in patients with AFib who were referred for catheter ablation. In the study, 82% of the patients with AFib, and no prior diagnosis of sleep apnea, were found to have sleep apnea on sleep testing.
Why Afib Patients Must Know Whether They Have Sleep Apnea
You know that Im concerned about the . You also know that .
Thus, a newly launched study investigating how breathing difficulties during sleep affect heart failure patients is very heartening in that hopefully well learn more about the relationship of sleep apnea and heart failure. That may have implications for those with atrial fibrillation that have either of these other conditions.
According to this study, up to three-fourths of heart failure patients have sleep-disordered breathing where normal breathing is disrupted during sleep. About two-thirds of those with significant sleep-disordered breathing have central sleep apnea, where breathing is shallow or stops.
This particular study focuses on central sleep apnea, which is different from obstructive sleep apnea. Central sleep apneas are caused by problems in controlling respiration, whereas obstructive sleep apneas are caused by collapsing of the upper airway during sleep.
CPAP machines are used in treating sleep apnea, and since this study is sponsored by a CPAP company, results will likely skew in that direction.
The goal is to determine if breathing support from an automated CPAP machine , one which adapts to breathing changes during the night, can decrease the progression of heart failure by maintaining normal breathing during sleep. The study results will likely contain important information for afib patients, but those results will be at least four years away.
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Can Afib Go Away On Its Own
Episodes of atrial fibrillation may come and go and resolve on their own in the earlier stages of atrial fibrillation. However, the long-term condition of atrial fibrillation is unlikely to correct itself if nothing is done. Atrial Fibrillation can be improved dramatically through a variety of methods including medications, procedures, and lifestyle modifications. Read more about common AFib treatments and success rate here.
Q: Im Experiencing Afib At Night Should I Be Worried
A: Its not uncommon for atrial fibrillation to occur at night. The nerves that control your heart rate typically are in sleep mode, and thats when your resting heart rate drops. Under these conditions, pacemaker activity from areas other than the normal pacemaker in the heart can trigger the onset of AFib.
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In addition, many patients with AFib have an underlying issue of obstructive or central sleep apnea. If you are frequently sleepy during the daytime, that is especially likely to be the case. If you suffer from AFib, sleep apnea can disrupt the hearts rhythms. This is a dangerous combination.
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South Denver Cardiology Associates Can Help
South Denver Cardiology Associates is the only cardiovascular practice in the Denver metro area with a complete system of care focused on achieving healthier lives. When you work with our team, youll benefit from award-winning comprehensive cardiac care that will help you alleviate your condition and improve your overall wellness.
Our comprehensive clinical cardiology services include diagnostic services as well as a wide range of treatment options that will address any cardiac condition you may experience. Our staff is up to date on the latest research regarding the link between sleep apnea and Afib, and we will recommend the correct testing to determine whether you may benefit from sleep apnea treatment.
Links Between Afib Sleep Apnea And Cardiovascular Health
A 2017 paper from Frontiers Neurology explains one barrier to establishing a causal relationship between AFib and OSA. Both conditions share common risk factors based on cardiovascular health.
In other words, many people who have both AFib and OSA also have cardiovascular issues. Its hard for scientists to rule out the possibility that a heart condition could be causing both AFib and sleep apnea.
In addition, this paper suggests a multidirectional link between AFib, OSA, and stroke. According to the researchers, AFib is a known risk factor for stroke, and the relationship between AFib and OSA might play a larger role in stroke risk than previously thought.
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