Link between sleep apnea and atrial fibrillation

Poor sleep habits are often a precursor to atrial fibrillation, and an important study published in the Archives of Internal Medicine points out that increased severity of sleep apnea is closely related to atrial fibrillation and ventricular arrhythmias. The latest research and findings in the cardiovascular field and shows how an EKG monitor can help assess heart function in patients with apnea.

In this study, two types of sleep apnea were compared after older men experienced an apnea event: obstructive sleep apnea and central sleep apnea. Of the two, it has been established that the most common form of apnea, obstructive sleep apnea, is associated with increased ventricular events. Central sleep apnea occurs less frequently and is closely associated with atrial fibrillation.

Obstructive sleep apnea is defined as a decrease in oxygen levels due to interruptions in breathing, which in turn stimulates the sympathetic nervous system to respond. Notably, half of all patients who experience atrial fibrillation also have obstructive sleep apnea. This strong association was stronger than the incidence of atrial fibrillation with any other risk factor.

Researchers believe the link between sleep apnea and high levels of C-reactive protein, an inflammatory marker of the presence of heart disease, is responsible for the increased prevalence of heart arrhythmias. Additionally, patients with obstructive sleep apnea are more likely to develop atrial fibrillation after electrical cardioversion than patients without any form of apnea. This relationship is even stronger when the patient in question is obese.

Although the study followed older men who experienced apnea episodes, the researchers believe the results will apply to women and men much younger than the study subjects. The study also assessed specific types of apnea; while many studies have looked at extreme forms of sleep apnea and compared them with patients without apnea episodes, few have looked at intermediate sleep apnea. Confirmation of sleep apnea and cardiac arrhythmias has been significantly enhanced.

In previous studies, researchers compared patients with very severe sleep apnea to those without symptoms. In this study, patients with moderate sleep apnea spectrum were studied and the progressive nature of the sleep apnea-arrhythmia relationship was confirmed.