Atrial fibrillation (A-fib) refers to a type of arrhythmia, which is an irregular heartbeat. It can cause blood to pool and move slowly, which can result in severe complications. Sleep apnea may cause A-fib.

Sleep apnea is a condition in which a person’s breathing stops and starts multiple times while they sleep. This can prevent their body from receiving enough oxygen.

A 2021 study indicates that people with sleep apnea have a 2–4 times higher chance of developing A-fib.

This article discusses sleep apnea, A-fib, and the links between the two. It also explores treatment and prevention for both conditions.

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People with sleep apnea experience stops and starts in their breathing during sleep, which may sound like snoring and gasping. This can prevent a person from receiving enough oxygen and cause poor-quality sleep.

People with sleep apnea are at higher risk of various conditions, including:

There are two types of sleep apnea:

  • Obstructive sleep apnea: This is the most common type of sleep apnea, which affects more than 20% of adults worldwide. In this type of sleep apnea, a person’s upper airway is blocked many times throughout their sleep, which reduces airflow, or stops it completely. This can happen when the airways become narrow, which may be the result of various conditions, such as changes in hormone levels, obesity, or large tonsils.
  • Central sleep apnea: This occurs when a person’s brain does not send signals to the body to breathe. Conditions that affect a person’s brain may cause this type of sleep apnea.

A person may not be aware they have sleep apnea. Often a partner alerts an individual to their symptoms. These may include:

  • loud, frequent snoring
  • stopping and starting breathing during sleep
  • gasping for air in sleep

A person with sleep apnea may notice symptoms such as:

People with A-fib have an irregular heartbeat, which doctors sometimes refer to as a quiver. Abnormalities in electrical signals in the atria, or upper chambers of the heart, cause arrhythmia. The malfunctioning electrical signals cause the atrial tissue to contract irregularly and cause an irregular heartbeat.

This can result in uncoordinated blood flow, which may cause blood to pool. The irregular rhythm can lead to serious complications, such as heart failure and stroke.

People with A-fib do not always experience symptoms. When they do, symptoms may include:

Research has found that the links between A-fib and sleep apnea are complex and likely bidirectional, which means each may contribute to the other. Both A-fib and sleep apnea are also risk factors for stroke.

Researchers have found it difficult to find a direct causal link between the two conditions. This is because, although the two are clearly linked, there are many other heart conditions also present in people with A-fib and sleep apnea. This makes it difficult to determine which symptoms and conditions are the causes and which are the effects.

Researchers suggest that a rise in A-fib and sleep apnea cases may be due to increases in obesity and cardiovascular disease. While A-fib is likely to contribute to the development of sleep apnea and vice versa, their close associations with other conditions like obesity make it difficult for researchers to confirm a causal link.

Animal studies have found potential direct links between A-fib and sleep apnea. These studies have shown that low oxygen levels and high carbon dioxide levels associated with sleep apnea can cause imbalances in the autonomic nervous system. This may play a role in changing electrical signals in the atria, which can lead to A-fib.

Research has also found that sleep apnea can cause changes in heart function and structure, as the repetitive closing of airways can cause stress on the atria, which may result in A-fib.

Doctors treat sleep apnea and A-fib separately. There are several treatment options for both conditions.

A-fib

Treatment for A-fib includes medication and surgery.

Medications for A-fib may include:

Surgery may include pacemaker implantation or catheter ablation.

Sleep apnea

Treatment for sleep apnea may include:

  • Breathing devices: These include continuous positive airway pressure (CPAP) machines and auto-adjusting positive airway pressure (APAP) machines.
  • Oral devices: A person wears these in their mouth during sleep. Examples include tongue-retaining devices and mandibular repositioning mouthpieces.
  • Surgery: Different procedures include:
    • surgery to implant devices to monitor and manage breathing patterns
    • adenotonsillectomy, to remove adenoids and tonsils
    • surgical removal of soft tissue from the throat and mouth
    • maxillary or jaw advancement surgery to move the upper and lower jaws forward to increase the size of the airway

Healthy lifestyle changes could help prevent A-fib and its complications and sleep apnea. These include:

Sleep apnea may cause A-fib, although the relationship between the two conditions is complex and likely bidirectional. Additional conditions such as obesity may also play a role in their development.

Some research suggests that sleep apnea may cause changes to the function and structure of the heart, which can result in A-fib. Other research suggests the presence of other heart-related conditions may play a key role in the coexistence of sleep apnea and A-fib.

A person may be able to help prevent A-fib and sleep apnea by making healthy lifestyle changes, such as following a healthy diet and stopping smoking, if necessary.

People should speak with a doctor if they are experiencing symptoms of A-fib or sleep apnea.