What is Sleep Apnoea and why does it matter in AF?
Sleep apnoeas are involuntary, prolonged pauses in breathing that can occur whilst asleep. The most common cause for this is ‘obstructive’ sleep apnoea (OSA). This literally means the airway is being obstructed for more than 10 seconds causing suffocation several times each hour.
The British Lung Foundation (BLF) reports that more than 1.4 million people in the UK are living with OSA, but scarily, it’s undiagnosed in up to 85% of people.
Early detection is important because it can have serious health consequences such as high blood pressure, heart disease, stroke, and diabetes. However, it’s easily treatable once it has been diagnosed. See the link below to the BLF website for how to spot warning signs in yourself/loved ones and what to do to get tested.
The reason we’re discussing it here today is that OSA is associated with AF. If you have OSA (even if you don’t know it) you’re 2-4x more likely to have AF. In the other direction, OSA may be present in up to 1 in 2 AF patients. So if you have AF, your healthcare team should consider screening for OSA, especially if you are overweight (a very strong risk factor for OSA as well).
Note: even if you don’t have AF, OSA is estimated to have a prevalence of up to 1 in 3!
Observational studies suggest that in patients with OSA and AF, AF progresses faster, anti-arrhythmic drugs are less effective and catheter ablation is more likely to fail.
Screening for OSA and optimal management as part of an AF management strategy is recommended by International guidelines. At the moment it’s only a recommendation because we don't have any evidence that treating OSA improves AF outcomes- these studies are ongoing. But putting AF to one side, the evidence is clear that treating OSA improves the quality of life. So if you experience excessive daytime sleepiness or have been told you may stop breathing at night time, go see your GP.