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AFib And Sleep Apnea: A Dangerous Duo

Atrial fibrillation (AFib) and sleep apnea seem to be linked. Side-by-side the two conditions are a precarious combination.

Many AFib patients suffer from obstructive sleep apnea–and vice versa.  

About half of patients with AFib suffer from sleep apnea, according to the Heart Rhythm Society. Those with sleep apnea are also about four times as likely to suffer from AFib.

While they seem to be associated, research about the connection between the two disorders is still developing. Both conditions increase the risk of stroke and premature death, and in tandem the effects appear to compound.

These disorders are often difficult to detect because symptoms can be hidden and often mimic other health concerns.

AFib is the most common cause of an abnormal heart rhythm. 

When patients are in AFib, their heart’s natural pacemaker no longer controls its rhythm. Symptoms can include an irregular pulse, heart palpitations, fatigue, shortness of breath and chest pain.

The majority of sleep apnea patients are undiagnosed. 

About 30 million people in the United States have sleep apnea, but the majority are undiagnosed. The disorder causes people to stop breathing while sleeping, which can have a long term impact on a person’s health. Symptoms can include snoring, episodes when breathing stops completely, dry mouth, sore throat and excessive daytime sleepiness.

There’s a close link between AFib and sleep apnea.

Research is ongoing, but here is what we know:

  • AFib patients are particularly prone to strokes, which are also a major risk factor of untreated sleep apnea.
  • Sleep apnea can increase the risk of other heart concerns, like high blood pressure and diabetes, which can also predispose a person to AFib.
  • Sleep apnea can activate heart rhythm concerns during sleep, which is particularly dangerous for a person with AFib. 
  • Untreated sleep apnea may also render AFib treatments, such as medications, ineffective.
  • Sleep apnea and AFib patients share common risk factors like obesity, age, heart disease and heavy alcohol use.

Concerns about sleep quality are worth questioning.
For those who have been diagnosed with AFib, sleep health is especially important. If sleep apnea is left untreated, it can damage the heart, causing rhythm issues, which are even more dangerous to AFib patients.

It is vital to assess your risk for obstructive sleep apnea.

Speak with your provider if:

  • You wake up in the middle of the night gasping or choking for air.
  • Your spouse is concerned that you stop breathing in your sleep.
  • You feel exhausted, even after a seemingly full night’s sleep (typically 7-9 hours for adults).
  • Your throat and mouth are very dry when you wake up.
  • You are restless throughout the night.
  • You snore very loudly.
  • You lack energy throughout the day and have lost interest in activities you typically enjoy.
  • You’re irritable and have an inability to focus.
  • You’ve gained weight.

If your doctor suspects you have any sleep concerns, they may recommend a sleep study to learn more.

If you have been diagnosed with sleep apnea, it also is important to keep a close eye on your heart health. This is especially important if you also have high blood pressure, diabetes, chronic kidney disease, lung disease, are obese or suffer from other heart concerns.

It is always  important to get regular check-ups and discuss any health concerns with your provider.



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Heart on pillow

Dr. Khan is a board-certified and fellowship trained pulmonologist specializing in Sleep Medicine and Critical Care Medicine. He received his medial degree from Punjab Medical College in Pakistan and completed his residency in Internal Medicine at the University of Connecticut, in Farmington, Conn., where he also completed a fellowship in Pulmonary Disease and Critical Care Medicine. His Internal Medicine fellowship in Sleep Medicine was accomplished at Drexel University College of Medicine, Philadelphia. Dr. Khan has worked at Yale University, School of Nursing, in Orange Conn. as a Clinical Instructor, and as a hospital based Pulmonary, Critical Care and Sleep Medicine consultant. Read more about Dr. Khan on our website.

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