sleep apnea and LAF

In 1998 I was diagnosed with AF. Around the same time I developed Obstructive Sleep Apnea. I visited the 'sleep doctor' yesterday and he claimed there was no connection between sleep apnea and AF *(In reading postings I have learned I have LAF). I just restarted the C-PAP after adding a humidifier and notice that I had AF when I put it on and when I woke up in the morning. It seems that the air pressure (only level 7) triggered it. Does anyone know if there is any connection between LAF and OSA? Any research to that effect?

John:
The longer I suffer with atrial fib, the more I become aware how little the doctors know about it, and often how much inaccurate information they impart to patients about it. Sleep Apnea is definately connected with afib, and is a trigger. Usually CPAP machines help a great deal. Perhaps your pressure settings are not right for you. It would seem that too much pressure from the machine could also trigger afib due to pressure on the vagus nerve. I don't know that; I'm just guessing, but we have several board members who have sleep apnea and CPAP machines. I'm sure you'll get more accurate information from them.

With regard to the OSA AF connection, I would post a URL number for you, but there are just too many sites describing this connection. Just google sleep apnea atrial fibrillation

Stay posted for better ideas than any doctor will give you.

Pam

Your doctor is seriously uninformed. I've been to several sleep docs and several heart docs and they all tell me that sleep apnea and afib are absolutely linked (although there is some disagreement in exactly how).

It is possible that the increased air pressure could trigger afib - my electrophysiologist tried to explain this all to me once but I sure can't recall. I had the same problem when I used to sing in a professional chorus - the process of warming up always triggered afib. Something about nerves in the airway being stimulated during the natural stretching that occurs under intense vocal warm-ups which involve increased air pressure in the lungs and airway.

Overall, once you get control of your apnea you should see an improvement in your afib.

On a different subject - I personally could not tolerate CPAP and looked for an alternative. I found a doctor who specializes in treating sleep apnea through dentistry and it has made a WORLD of difference. Now I sleep with a simple retainer that pushes my jaw forward thus opening the airway. MUCH better than cpap - I don't know why more sleep docs don't suggest this. For more information try this: [sleepapneadentist.com]

Good luck!

If you have more questions feel free to email me directly: davepublic1@trahans.net

In my own case my wife kept telling me I was snoring more and that I hadn't snored so much when we had gotten married. I was set to go to a sleep clinic when I got a date for my ablation. Since my ablation I no longer snore at all. No afib no snoring. In my case the afib seems to have caused the snoring.

I don't know much about sleep apnea although I think my husband may have it and I may have also. We are both "overweight." I do know that weight seems to be a factor. My afib has been better since sleeping in a recliner with my neck supported by a rolled-up towel. For what it's worth, my husband's father had apnea and when he lost a whole bunch of weight the apnea went away.

I keep coming back to the concept of anything that compresses the vagal nerve, whether it be bloating from gas or constipation or air pressure or outside pressure such as too much weight is a major factor in AF. But perhaps it's not a standalone cause. It could be pressure of some kind and/or free glutamates accumulated in the body, or simply free glutamates accumulated. I look at all the years I ate crap and have been overweight and haven't had afib until now (although as I look back I can see definite signs of it for years before it burst into full-blown afib).

It seems everybody's getting afib now. Is it that it is finally "catching up" with us after a lifetime or poor eating and poor bowel condition, as well as other factors?

k

Bruce:

When my husband was my boyfriend, he never snored. In fact he didn't snore until our wedding night. I think it had something to do with that piece of paper, you know, the marriage certificate.

All joking aside, he doesn't have afib, but can take the roof off at night. If he does have apneic periods, they are very brief, perhaps 10 or 15 seconds. However, his snoring does occasionally wake him up, that is if I don't. He had a laser procedure that didn't work on him at all. When he went for it, he was told it sometimes had to be repeated once, but usually worked. After one procedure, the doc changed his mind and told my husband that repeating the procedure was not going to work in his case and referred him to an ear nose and throat specialist. (This doctor was a pulmonologist). Our insurance didn't cover the laser procedure; and we were out $800.00. I know, we sound like dumb guinea pigs. My husband finds the most help with the dental device.

I wish he was still my boyfriend.

Pam

Dear folks! Thanks for the many informative and caring responses.

Pam: I will check out some of the URLs regarding apnea and afib.

David: I also sing (baritone) in a 24 member professional group and had to drop out four weeks ago when the afib got so bad that it affected my singing. I will check out the web site for dental devices. I have a hard time tolerating the CPAP machine.

Again, thanks for your information and affirmation. It makes a positive difference. john

PS: I am also going to go on a six week trial with the CPAP to see if there's a reduction in frequency and duration of AFIB events. john

[www.ncbi.nlm.nih.gov]

[www.healthfinder.gov]

FWIW I also get occasional sleep apnea along with occasional night-time AF (typically 3 - 6 am duration and self-converting), though I can't say I've experienced a correlation........... but then again I am asleep when one or other of them have occurred. Whilst I have had nocturnal AF for some 4 years that I know of (5 episodes to date plus one non-nocturnal 10.30pm possibly alchohol-(a LOT)-induced episode), I can remember awaking seriously gasping for breath for at least 20 yrs (although thankfully not often - probably once or twice each year on average).

Mike F.

There certainly may be a connetion between afib and sleep apnea, since apnea has been documented as a producer of higher blood pressure, a risk factor for heart disease and/or stroke, as well as the obvious problems of daytime headache and tiredness from sleep deprivation. But the connection to the CPAP machine cannot be a factor--or at least not one that is universal. I use a CPAP and don't go into AF at night. My AF is induced mainly by stress (exercise and other stressors) and the CPAP only helps with sleep and the lack of after-effects from sleep deprivation, which is what apnea causes.

I'd like to know more about the dental set-up, because although I tolerate the machine well enough, it is cumbersome, especially when traveling.
Any information as to how effective the dental device is would be appreciated.

Tom

I was diagnosed with LAF and obstructive sleep apnea about the same time, this past August. In fact it was my cardiologist who requested the sleep study. My husband has a severe case of OSA and has been using a C-pap for 9 years now (which has GREATLY improved the quality of his life, I might add).
I got my C-Pap in October and have learned to tolerate it quite well. I asked my cardiologist if it would "cure" my LAF and he said definitely not. I do not believe the pressure from the machine has caused any of my (very frequent and long) episodes of AF, but I used to wake up in the morning and be in AF a LOT of the time. That has at least subsided. Now if I could only get all the other day/evening episodes to vanish as easily!

John, a pressure setting of 7 is low. Mine is at 11 and my husband's is at 15. Yes, we look lovely at night, both of us "hooked up". It's hysterical.

Good luck to you.

Cathy

Bruce C hinted about this and I've mentioned it before but it bears mentioning again:

A recent study discovered, quite by accident, that patients who had received pacemakers to treat arrhythmia issues ALSO get their snoring/apnea cured as a side affect. I find this extremely interesting.

Here's my simplified theory as to what's going on here: poor vagal tone makes you "too" relaxed - your heart beats too slow at times (especially during sleep) which leads to arrythmias; it also causes your muscles to relax "too" much during sleep which causes snoring and apnea. Installation of the pacemaker prevents your heart rate from getting too low which in turn keeps the flow of oxygen through the system higher, which in turn keeps your metabolism cranked up so that you never get so "relaxed" as to start snoring.

Dear Cathy, At Pam's suggestion I googled "sleep apnea atrial fibrillation" and retrieved a study published by the Mayo Clinic on May 27, 2003 that links OSA to AF. A year after cardiovrsion "AF recurred in 82 percent of patients with untreated OSA, compared to 42 percent in the treated OSA group." You can the report at this URL: [www.pslgroup.com]

Sincerely, john

Dear David, Now, there's an interesting "what comes first - the chicken or the egg" question. The Mayo docs suggest that untreated OSA could be a primary cause of AF (URL: [www.pslgroup.com]) and your conjecture is that poor vagal / muscle tone might contribute to both OSA and AF. The website, sleepdisordercenter.org, in an article published in 2000 observed that people with a Body Mass Index (BMI) of 25 or less rarely had OSA. While the Finns noticed an increase in AF among heavy cardio-exercise population I wonder if there have been any studies that link lower BMIs to lower incidence of AF? john

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John - you posed the conjecture about whether AF is related to BMI. Judging from the reaction doctors get when I tell them my case history, that would appear annedotally to be true.

I've always been a thin guy - 6'2" around 185 pounds. Every doctor I meet says that I don't fit the profile for AF or OSA and they are pretty surprised at my symptoms.

Dear David, I "hide" my weight well. At 5'10" I am currently 178 lbs when I weigh in in the morning (down from 197 this past summer). The sleepdisordercenter.org weight chart suggests that I should be between 165 and 175 with a BMI of 25 or less to rid myself of apnea. Of course, the key is the BMI since a person can be 'thin' but not 'fit'. So, I have been doing some moderate weight lifting every other morning in conjunction with some slow yoga stretches. In addition, I try to walk or cross-country ski about at least 45 minutes a day - all this to get my BMI down to around 25 and see what happens to the apnea.

john