Heart Patients Must Treat Sleep Apnea
Deadly Atrial Fibrillation Recurs in Untreated Patients
May 28, 2003 -- If you've had atrial fibrillation, find out if you also have sleep apnea. Why? Without proper treatment, sleep apnea is very likely to make your heart problems return.
Atrial fibrillation is a dangerous condition in which the heart loses its rhythm and flutters wildly instead of beating regularly. It often leads to heart failure. Fortunately, doctors can use an electric device to shock the heart back into rhythm.
Sleep apnea is dangerous, too. It happens when a person's airway becomes blocked during sleep and oxygen levels become low. The most effective treatment is a device that pumps air into the nostrils as one sleeps, keeping the airway open. It's called CPAP, for continuous positive airway pressure.
Virend K. Somers, MD, PhD, and colleagues at the Mayo Clinic in Rochester, Minn., suspected that sleep apnea might lead to a return of atrial fibrillation. They studied 39 patients with sleep apnea. Twenty-five of them weren't using CPAP, and two others weren't using it every night.
Within a year, 82% of these 27 patients had another episode of atrial fibrillation. This happened to only 42% of patients treated for sleep apnea.
The researchers also studied 79 atrial fibrillation patients without sleep apnea at the beginning of the study. More than half -- 53% -- had another episode of atrial fibrillation. Many of these 79 patients were obese. Sleep apnea is common among obese people. Somers and colleagues suspect that recurring atrial fibrillation in many of these patients, too, was due to sleep apnea.
The researchers suggest that some atrial fibrillation patients should be screened for sleep apnea:
- Those who are obese
- Those whose spouses say they snore loudly
- Those who have daytime sleepiness
The report appears in the May 27 issue of Circulation: Journal of the American Heart Association.