Treating Troubled Sleep to Treat a Troubled Heart

Atrial fibrillation was less likely to recur with sleep apnea therapy CPAP

(RxWiki News) Irregular breathing from sleep apnea has been linked to the irregular heart rhythm called atrial fibrillation. Treating sleep apnea, however, may lower the risk of atrial fibrillation happening again.

A new review of past research found that continuous positive airway pressure (CPAP) may lower the odds of atrial fibrillation coming back in those who have had this abnormal heartbeat.

People with obstructive sleep apnea (OSA) have pauses in their breathing when they are asleep. This may heighten the risk of high blood pressure, heart disease and stroke, said Trieu Q. Ho, MD, a cardiac electrophysiologist and medical director of cardiology research and education at Baylor Regional Medical Center at Grapevine, TX. Apnea patients may help their condition by using a CPAP machine, which eases breathing during sleep.

"OSA has been independently linked to multiple cardiovascular outcomes," Dr. Ho said.

Dr. Ho added, "Patients with risk factors and symptoms should discuss with their doctors for further evaluation."

Larry A. Chinitz, MD, of the New York University School of Medicine in New York City, and colleagues looked at seven past studies representing 1,087 patients.

"Active screening for obstructive sleep apnea in all patients who undergo treatment for atrial fibrillation is imperative as the use of CPAP will influence the outcome of therapy and likely reduce some of the cardiovascular morbidity associated with atrial fibrillation," Dr. Chinitz said in a press release. "Technology for home screening of sleep apnea needs to be made widely available and become as routine as measurements of blood pressure and blood sugar levels in diabetics."

CPAP appeared to cut the risk of atrial fibrillation recurring by 42 percent in patients with OSA, Dr. Chinitz and team found.

A CPAP device uses mild air pressure to keep the airways open. CPAP machines feature a motor that blows air into a tube. That tube connects to an element that straps over the nose or nose and mouth.

With atrial fibrillation, the upper chambers of the heart (the atria) beat abnormally. As a result, blood does not effectively move into the heart’s ventricles. The American Heart Association estimates that 2.7 million Americans have this condition, which raises stroke risk.

Atrial fibrillation may be treated with medication or ablation, a procedure that deadens that heart tissue that is causing the irregular rhythm.

Even with medication and ablation, atrial fibrillation recurs for many, Dr. Chinitz and team noted. OSA is a known predictor for recurrence.

“Sleep apnea, along with several other conditions including hypertension, obesity and diabetes, actively contribute to the onset and progression of atrial fibrillation,” said David J. Wilber, MD, editor-in-chief of the Journal of the American College of Cardiology: Clinical Electrophysiology, in a press release. “This study provides important evidence that we need to identify and treat these associated conditions if our more direct efforts to suppress the arrhythmia by antiarrhythmic drugs or ablation are to be effective."

This study was published April 20 in the Journal of the American College of Cardiology: Clinical Electrophysiology. Dr. Chinitz received fellowship grants from Biotronik, Medtronic and Boston Scientific. Dr. Chinitz also served as a consultant to St. Jude Medical. The authors disclosed no funding sources for this study.

Review Date: 
April 20, 2015