Atrial Fibrillation, commonly known as AFib, is the most common type of heart arrhythmia or irregular heartbeat. AFib affects nearly 6 million people in the US, according to the Centers for Disease Control and Prevention, and it is estimated that 12 million people will have AFib by 2030. Typically the upper chambers of the heart (atria) and the lower chambers (ventricles) work together to pump blood throughout the body. With AFib, there is a change in the electrical activity of the heart, which causes the atria to beat faster than normal. As a result, blood pools in the atria, increasing the chance of blood clots and stroke. The risk factors for developing atrial fibrillation include:

• Being over the age of 60.

• Having high blood pressure.

• Diabetes or coronary heart disease.

One less known risk factor is obstructive sleep apnea, or OSA. Recent research reveals the commonalities between these diseases and their bidirectional relationship.

Sleep apnea is an increasingly common disorder affecting up to 22 million Americans. Obstructive sleep apnea, the most common type, is caused by a narrow or blocked upper airway, resulting in disrupted breathing during sleep. These breathing interruptions result in the symptomatic snoring and gasping for air often associated with this sleep condition. People with sleep apnea suffer from daytime sleepiness, fatigue, and lack of mental clarity. If left untreated, sleep apnea can lead to cardiovascular disease, high blood pressure, stroke, and AFib. 

Research from the Heart Rhythm Society estimates that about 50% of AFib patients also have sleep apnea, while sleep apnea patients are four times more likely to develop AFib. The strong link between the two conditions is reflected in their shared risk factors. Having AFib or sleep apnea increases a person's risk of stroke, diabetes, high blood pressure, and heart disease. Both AFib and sleep apnea are becoming more prevalent in the US. One reason for this increase is due to our country's escalating rates of obesity and heart disease, which are common conditions in both AFib and sleep apnea patients. 

The physiological changes that occur in the body during a sleep apnea event are at the core of the sleep apnea AFib connection. When breathing stops and starts throughout the night, oxygen levels in the blood drop. Our bodies respond by releasing the stress hormone epinephrine. This response elevates the heart rate and can create an arrhythmia or irregular heartbeat. Overall, heart function decreases because it becomes less efficient at pumping blood and because of the pressure changes in the chest. This puts sleep apnea sufferers at higher risk for cardiovascular disease and heart attacks in addition to AFib.

Because these two conditions often co-occur, new research indicates that treating both diseases leads to better patient outcomes. Studies also show that untreated sleep apnea prevents certain AFib treatments from working most effectively. If you have been diagnosed with sleep apnea, treatment with CPAP (continuous positive airway pressure) will help regulate your breathing, reduce symptoms and mitigate the risk of cardiovascular conditions such as AFib. If you have both conditions, CPAP can work with your AFib treatment. Many cardiologists also recommend their AFib patients be screened for sleep apnea. Catheter ablation, a minimally invasive procedure using a catheter and radiofrequency to return the heart muscle to its normal rhythm, is most successful when sleep apnea is treated with CPAP. Because both AFib and sleep apnea are linked to serious health conditions, it is important to work closely with your healthcare practitioner to find the best treatment plan. Long-term lifestyle changes such as losing weight and regularly exercising will go a long toward staying healthy and mitigating the risk of developing sleep apnea or AFib.