Sleep Apnea Severity Increases the Risk of Atrial Fibrillation and Ventricular Arrhythmias

June 24, 2009 5:21 AM CT

We continue to learn more about the relationship between sleep apnea and atrial fibrillation. The importance of this correlation was highlighted at the Heart Rhythm Society AF Summit in May.

In a study just published in the Archives of Internal Medicine, increasing severity of sleep apnea was found to be associated with a progressively increasing risk of atrial fibrillation and ventricular arrhythmias.

In previous studies, these same researchers had evaluated those with very severe sleep apnea and those without. In this study, those in the middle sleep apnea spectrum were studied and the progressive nature of the sleep apnea-arrhythmia relationship was confirmed.

The type of sleep apnea correlated with the type of arrhythmia. Obstructive sleep apnea, the most common form, was associated with an increased risk of ventricular events. The much less common form, central sleep apnea, which is common in heart failure, was associated with an increased risk of atrial fibrillation.

According to investigator Dr. Reena Mehra, with obstructive sleep apnea, “oxygen levels decline and you get a fight-or-flight response and sympathetic nervous system activation. Central sleep apnea is different, from the standpoint that there are neural mechanisms at play that are the reasons for these episodes of stopping breathing.” She speculated that, “treating the sleep apnea may help improve the arrhythmia-related outcome”, but cautioned that trials would be needed to confirm that.

While the study was done on older men, it’s likely that it applies to younger men and to women of all ages. Anecdotally, we have seen this correlation in all ages of women and men with afib.

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