May 18, 2012

Do You Have Sleep Apnea and Atrial Fibrillation? Why Does It Matter?

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Many of you know that I’m concerned about the relationship between sleep apnea and atrial fibrillation and also about how atrial fibrillation can overwork the heart and lead to heart failure.

Thus, a newly launched study about sleep apnea and heart failure may hopefully provide information useful for those with atrial fibrillation.

What are the implications today for those with afib and should you be tested for sleep apnea?

Read more at Why Afib Patients Must Know Whether They Have Sleep Apnea

Then please come back here to post your comments, thoughts, and experiences.

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jlwyatt11 5 pts

I was diagnose with sleep apnea in 2008. I have been using my CPAP faithfully since. I have had 4 episodes of afib. in last 11 years, at intervals of 3 to  4 years. The 1st two times in 2000 and 2004 I went back into sinus fib or regular rhythem on my own. The last two times I decided to go to the hospital and both times they said I have afib. I asked why if it episodic? They said basically better safe than sorry to take Calcium blockers. I've been worried  about taking this medicine since. Has anyone else had this experience. IS there a support group somewhere?

This is a "chicken and egg" thing for me. After I was diagnosed with A-Fib, a doctor suggested having a sleep study done but my arrhythmia was so frequent and long-lasting that they recommended an ablation ASAP. I had a cryo-ablation done at Baylor's heart hospital in Dallas last week.

One of the first things I've noticed is how much better I'm sleeping and that I'm waking up easier and feeling rested. I have problems with fatigue because of auto-immune diseases. I tire easily and feel like my bones are made of lead at random times. But when the A-Fib started, I mostly got the worst of it at night or early in the morning. I awoke feeling as though I'd been fighting battles!

So, did sleep apnea cause my A-Fib or did the A-Fib mess up my ability to sleep well and provoke apnea? I don't know. My doctor at Baylor said I had an electrical problem in my heart and was likely born with it. We don't know what set it off.

For those considering ablation, I have to say it's not nearly as bad as the internet articles make it sound. First off, I was given general anaesthesia and wasn't awake. Secondly, if you can, have the cryo-ablation done instead of the older, electrode version. Apparently, cryo has a much higher success rate and fewer possible complications. It's only been FDA-approved in the US for about a year, I believe, so it may be harder to find a hospital that offers it. That's why I went to Baylor.

Does sleep apnea have to be a certain severity to cause afib?
I have had 4 sleep studies- one doc say I have mild OSA and can be th cause of the arrhythmia another says it isn't bad enough to cause my afib and other arrhythmia. I have been on and off CPAP twice now, no doctor can agree whether I have obstructive sleep apnea, my last study showed an increase in central apneas but not that much of an increase and they say that is because I was on CPAP. I am already prone to arrhythmias due to congenital heart defect ( ASD) and have bi-vent paemaker. all of my doctors do agree that sleep apnea has to be very bad to cause afib. but they don't agree on whether CPAP would help or hurt me. CPAP seems to help me some days but not others so sleep doc wants me on it but pulmonologist says no. I am confused.

I am actually the reverse of many of our posters here on the forum. I was diagnosed with obstructive sleep apnea about a year ago and was prescribed a CPAP machine. I tried to use it, but eventually just gave up on it. Then I had my first, and hopefully only A-fib episode this past December. As soon as they found out that I wasn't using my CPAP, they agreed that that may have very well been the cause of me going into A-fib. The A-fib episode scared me so badly (my heart was as high as 234 at one point), that I began using my CPAP there in the hospital and haven't stopped since. I have already begun to see the daytime fatigue fading away and some of my mental capacities such as memory come back, as well as having just the basic energy level to do chores, etc. In the past I had been napping quite often. I continue to have what appears to be A-flutter, but no A-fib again yet, although it has only been about 30 days. My cardiologist hopes that if I resolve the apnea, through weight loss, that hopefully the A-fib won't come back and I will be in a better state of health overall. I never knew how dangerous sleep apnea was until I ingored it....

Jackie,

I'm glad the CPAP is helping. Hopefully you will never have afib again.

Mellanie

I have had a-fib for years. Usually 4-6 attacks a year lasting several days. I am on Flecanide which seems to help with controlling it. In late July I had an episode that went on for ten days. I had a cardioversion to get me out of it. At the end of the cardioversion, the doctor said I should have a sleep study done. I did, and was found to have sever sleep apnea. I have not had an episode now for 11 weeks since I have been using the CPAP. I am cautiosly optimistic.

Dennis,

That is excellent news that the CPAP is helping. I hope that you don't have afib ever again.

Mellanie

I am a 34 yr old male. Was diagnosed with paroxysmal A-Fib 2 yrs ago after I went to the ER with tachycardia. I did not need to be cardioverted, but was given about 4 hrs of medication via drip to get me back to "normal". Previous to this incident I was seeing a cardiologists and having the routine tests done. All came back as a "normal and healthy" 32 yr old. I knew I was having weird sensations that were not right, but they never seemed to happen when I was actually being watched or tested, go figure. They were all telling me it was just anxiety. I have medication that I can take if I have any symptoms. I seem to go without any hiccups its seem for weeks, if not months, then all of a sudden, starting with last week, I am waking up in the middle of the night, feeling like I was holding my breath. 2 days ago this was accompanied with 2 hrs of A-fib or another arryhthmia. Really got me worried, being 34 and in decent shape and all. I find this correlation between these 2 conditions interesting and just want some answers. I will be seeing my doctor (new) about this and see what else can be tested.

Gary,

Have you been tested for sleep apnea? It sounds like a good possibility in your situation. Please keep us posted.

Mellanie

Is there anyone who has paralyzed diaphram after byPass surgery with AFib and OSA?

Juyeonsong,

"Is there anyone who has paralyzed diaphram after byPass surgery with AFib and OSA?"

Can you elaborate to help us better understand your question?

Mellanie

I just had an left Atrial Ablation for persistant AFIB. I woke up from the proceedure and immediately felt like a million dollars. I had been in continuous AFIB for many months before the ablation, and couldn't believe how relieved I was to be back in Rythym. The proceedure was not that bad and I did not even require pain meds at all afterwards. My proceedure was done at Memorial Herman Medical Center in Houstn, TX at their Cardio Vascular Institute. I highly recommend them for the great service I received. Now I am going to do the CPAP portion of my APNEA test since I was also diagnosed with mild Sleep APNEA prior to the Ablation.
Hope this helps anyone considering an Ablation for AFIB. I'd do it again in a "Heartbeat".

Aubrey,

Congratulations on your success. Please stay on the CPAP in order to help keep that afib beast at bay.

Mellanie

Mellanie,

Thanks for the advice about AV Node ablation. I see the EP soon and will keep it in mind. Also, have u ever heard of a mild case of sleep apnea causing A=Fib.
I had a sleep study and they said I didn't have enough to cause my A-Fib. I'd like to have another study done because some nights I snore much much more than others and maybe I didn't snore as much during the little sleep I got during the study.

Thank you,
Marian

I have read all comments on your blog and notice that nobody said that their Drs
suggested Pacemaker. I have had PVC' and irregular heartbeat for years. Recently, my cardio doc put me on a halter monitor and found A-Fib with 2 to 3 second pauses during sleep. I had a sleep apnea study but apnea wasnt enough to cause the pauses. He suggests a Pacemaker because I have the pauses andTachacardia and bradycardia. Pacemaker will adjust slow rate but I will need meds for the fast beat. I'm also on Pradaxa to prevent blood clots and stroke. Has anyone else been suggested to get a pacemaker for these pauses, fast beats and slow beats. I'm going to see an electrophysiologist to confirm that a pacemaker is necessary.

Marian,

Generally pacemakers aren't used for treating afib itself, other than keeping the fast afib from transmitting to the ventricles (the lower chambers of the heart) and causing life-threatening issues. Pacemakers are generally for other types of beats that are regular, usually the slow beats (bradycardia). The electrophysiologist should be able to judge whether or not you need a pacemaker, but you may wish to do your homework first so that you don't end up with an AV node ablation. See our story here for more details:

AV Node Ablation: Why You Shouldn't Have It

Mellanie

Wow, I have been having paroxysmal A-Fib since 1997. I have never been cardioverted and always return to a normal rythum on my own typically within 6 to 10 hours. 95% of all of my occurrances start between 1:00 AM and 3:00 AM. I wake right away and don't fall back to sleep during an attach. I met a fellow who had both A-Fib and Sleep Apnea and said I should get checked. Since I started having A-Fib (about 2 to 4 attacks a year) I always asked my Cardiolgist about what may be going on during the night to trigger A-Fib. So last night I had a sleep study done and bang, i have severe sleep apnea and went into A-Fib that started at 1:00 AM and ended at 3:00 AM. Interesting. So I am going to treat my sleep apnea and I bet it fixes me right up. so I hope. Thus, take it into your own hands and make sure you ask the question. It may help you like to looks like it will help me. Oh, I was 44 when this all started.

David

I have been battling AFIB since my MI in 92 and my bypass in 95. I recently went back and had a sleep study. They prescibed a BiPAP and honestly while it is a real challenge getting to sleep with the mask on it does reduce the episodes of AFIB and it is nice to dream at night again. I usually wake up after a few hous of th emask on but to sleep without it on a nite means a certain episode of AFIB after a few nites.

I have been on BiPap for 5 years and recently had A Fib. I was told that the key is not to undergo cardioversion until you have been scoped for blood clots in the area of the lungs or been properly treated with anticoagulents such as Pradaxa. I was insructed that if you are cardioverted, without addressing the danger of a blood clot becoming an emboli, you could be returning with a stroke. I have been on Toprol or Rythmol to control my arrythmias but it is CRUCIALto treat the dangerous side effect of blood clots. BiPap is wonderful and you will be amazed at the rise in energy and memory you will see returning. If the CPap is too uncomfortable make certain to tell your physician so that they can cover you through insurance for BiPap which allows you to breath out comfortably without a constant force of air. I hope this might be helpful in questions for your physician. Check with your doctor though!

I have been in A-Fib for 20 days. Nights are unbearable, up and down, very
little sleep. Days are better, I even have played golf at 130 and have it come down to 92, always with broken HB. The meds to nothing to bring it down.
I have an appointment Monday with the cardio, after having to wait for a referal
even though I have seen him 7 times. I am 79 and athletic all my life, but
this is hard to deal with.

I have been living with paroxysmal a-fib since 2004, its getting worse now and after 10 doctors one decided to send me for a sleep study. Now i have been diagnosed with OSA. Now what? I am told now this cpap may correct the a-fib if not then its time for the pulmonary vein ablation??? Im afraid and i dont know what to do HELP???

Dear Melanie,
I was diagnosed with paroxysmal A-Fib in Dec. 05. Since then I have seen 4 different cardiologists in the great medical center heaven of Houston, TX. None have ever mentioned sleep apnea which seems strangely awful. Since my first attack, I have had 2 more attacks, the last of which was in June. Each time, I am converted to sinus rhythm by taking more Beta Blocker (Sotolol). Each time, I am almost unable to recognize the event which has always occurred at bedtime. The only symptoms are a headache, difficulty falling asleep and frequent urination. My current cardiologist feels that I may be a candidate for a pacemaker in that my heart rate goes too low when the Sotolol dosage is at a level that he thinks would prevent A-fib episodes. Because there is a possibility that I had 2 recent ischemic strokes, he put me on Pradaxa even though he never mentioned a blood thinner previously. He has never mentioned the risk of the beta blocker wearing off.
During my last hospitalization, a sleep lab MD visited me and urged me to be tested at his lab. They have since concluded that I have sleep apnea and I will see the MD at the end of this month and imagine he will fit me with a CPAP or ??.
When I last visited my cardiologist, I asked him about ablation and he referred me to an electrophysiologist. Now I am wondering of I should put that off until I learn the effects of the CPAP.
I should point out that as best I can tell I feel fine and have good energy levels for a 72 year old.
Any suggestions???

Mellanie:
I have had a-vib for three years now and have had two ablations done during that time. I am 43 and decided to have a sleep study done since my sleep has always been terrible and I am always tired. Last week I was diagnosed with moderate sleep apnea and just got fitted with a mask on Saturday. I have many questions that I do not know where to go for answers!! Does sleep apnea cause a-vib? Is there any up to date info on the relationship between the two(your article was back in 2009) This unknown is causing alot of fear!! I live in Mckinney Tx and see you are in Decatur- I would really appreciate advice on what to do next.. What doctors to see that have experience with this, anyone I could talk to that has the same problem. My sleep study people seem disconcerted and just think by sending me a CPAP machine, my symptoms of avib will go away. Any help on getting educating educated on this and having someone answer my questions would be greatly appreciated.

Rich

3 years with cardiac trouble including afib, brdycardia and pvc's, apc,s. I have seen 7 different docs incl. 2 cardios. 3 times - have been on a 3 week cardionet monitor. Results instantly show hundreds of episodes of nightly afib and heart stopping for 3-5 seconds. It was 2 days ago I was talking to a friend who works for a comp that sets up cpaps and she ask me if I get tired during the day...I said every day of my life I want to sleep all day...I figured it was some fatigue syndrome! How could 7 doctors with the evidence from the cardionet reports never have suspected sleep apnea? They put me on stupid lopressor which even in low doses causes me to have a heart rate of 35-40. I don't know how to feel...thanks for listening!!

I wish you had some literature to discribe both conditions that you migh be
able to mail to some one instead of going though the computer

I have sleep anea and AF (In form of a very irregular heart beat, which I probably have had most of my life) I have been on a APAP machine for 5 years now and it works very well. I have no trouble in sleeping 7-8 hours a night on the machine and my average AHI is 4.8. Lately however I have developed high blood pressue and am wondering if there is a connection. I have got into the habit of sleeping in for about an hour in the mornings ( I am retired) without the machine and am wondering if could affect my blood pressue.

I also have REM Sleep Behavior Disorder but it doesn't seem to affect the APAP machine except when I throw myself out of bed.

any thoughts?

Ross

I have been in and out of A-Fib for the 5th time in 5 months.
When I am in it I feel terrible.
Out I feel fine.
Yesterday, I was in a-Fib but decided , the hell with it, I'm
playing golf. I took my pulse reader with me and after nine holes
and not doing badly, I took my readings which were 140/70 P-65,,
with no PVcs (for the first time in 15 hours or so..
I remained in rhythm until last night while resting watching
TV my pulse dropped below 40 for 5 - 10 minutes. i went to bed.
This morning it's around 135/65 P49 but still with PVCs. My
heart seems to like being active and not resting. I will discuss
this with my cardio on the 18th. Need a pacemaker? my friend did
it took him out of A-Fib.

Jim,

Good luck figuring that one out. You may want to consult with an electrophysiologist, which is a specialized cardiologist that deals with heart rhythms.

Before considering a pacemaker for afib, you may want to do some homework. Pacemakers by themselves do not stop afib. He may have had an AV node ablation with it. Here's an article talking more about that: AV Node Ablation: Why You Shouldn’t Have It: http://bit.ly/GQY8N

Mellanie

Is anyone on here old enough to have served in Vietnam? I'm trying to find out if there is a relationship between sleep apnea and agent orange. My sleeping and breathing patterns changed shortly after returning fron Nam.I also have a-fib. Please respond if you have any info.

dsmith,

I haven't read anything about a correlation between sleep apnea and agent orange. We do know that environmental issues, including pesticides, can be related to afib, but I don't know if that relationship is through sleep apnea or not.

Mellanie

I have had atrial fibulation for years and 4 years ago they did the maze sugery. I also have a CPAP machine that I use nightly. Since my maze surgery I have been diagnosed with Alpha ! (Hereditary Emphaszma) and on oxygen (2 flow) daily and nightly along with my CPAP. My afib was nearly gone after my surgery and now after 4 years and a being a newly treated Alpha 1 patients receiving Prolastin C infusions weekly my atrilfib seems to be returning in the last several months. I am going to the cardiologist tomorrow but I'm trying to see what could be messing me up again. Is it the heart itself? is it the prolastin? could it be my thyroid? I can't take anymore medications or I'll explode do you think I would be a candidate for the surgery again. I've been told they can't do the maze surgery more than once. Any comments would be helpful.
Vickie S

I had catheter ablation two yrs ago after being diagnosed with both A-Fib and Flutter. I had passed stress tests, echo exams and weight and blood pressure readings. The ablation procedure was NOT successful and I'm consigned to taking Jantoven to thin my blood.

I think my Cardiologist SHOULD HAVE at least mentioned that Sleep Disorder could be causal.

It turns out that I have Obstructive Sleep Disorder and I've recently begun using a positive air pressure system.

I believe that not only will I enjoy more therapeutic sleep but that I will alleviate my Atrial problems.

I think sharing information like this could streamline a process of more effective treatment.

I am really really disappointed in the (cough) system of health care which seems to have incentivized inefficiency.

I have been in Afib since October 2010. I have had two chemical conversions...that did not work. I went in February 2011 and got my heart shocked....lasted two days..went back into afib...converted back to normal rhythm that night...but then the next day was back in afib where it has stayed...now March 2011. I went 3-1 for sleep apnea. Went a coupe days ago and found I do have a form of sleep apnea. Not completely cutting off my airway but my oxgen levels are going way down and everything my airway is alost closing I wake up....and am not reaching the restful stage of sleep but onlly for short periods during the night. My heart doctor suggested the test and felt sure I would test positive because i stopped breathing while under for the heart shock. So now I will use the cpap or whatever they decide suits me best for a few months and if my heart doesn't convert on it own...I guess we will be doing another heart shock (.I will have to continue the sleep machine) I seem to stay tire all the time or if I do feel good and do much I feel exhausted. and I have always been a hyper person. Does anyone else staying in afib feel the exhaustion. heart doctor says it's because of the afib.

I've had sleep apnea for several years now; in Oct. 2009, I developed a fib. After being treated, I had cardioversion in May 2010. It worked the first time. However, sometime between Jan 24, 2011 and Feb. 3, 2011, I went back into A fib. Cardioversion was done again, but did not work. I use my bi-pap machine. Any suggestions?

Joyce,

I'm sorry you're having so much difficulty. It's good that you're using your BiPAP machine. Have you tried any medications yet? Sometimes they help keep you in sinus rhythm after cardioversion.

Mellanie

Early hours of 30 July I had a heart attack. I got lucky. With excellent medical care which included the insertion of 2 stents within 3 hours of the attack in my Left Anterior Artery I think I am recovering well. I'm back to work, playing golf etc.

The only real downside has been a couple of side effects which may be linked to my medication or have some other cause.

In hospital I was put on a cocktail of drugs including the beta blocker Bisoprolol and everything was great for 3 weeks until I woke at around 4 a.m. one morning with a very fast irregular heartbeat.

Called an ambulance, into hospital, checked over. BP fine, no chest pain or other issues but AF continued for an hour or so until they stuck a needle in me to take blood. Heart rate and rhythm settled back to normal at that point.

Cardiac Registrar diagnosed Paroxysmal AF and advised my GP to change the Bisoprolol to Sotalol at 80mg twice a day. My GP made the change and gradually intoduced me onto Sotalol. I started with 40mg bd then 40mg a.m. and 80mg p.m. then up to the full dose. This was over a 4 week period.

Almost as soon as I got to the full dose, I had a further bout of AF again at around 4 a.m. with the same result. Ambulance, hospital, checkover, needle - it stopped. The only difference this time was that I had drunk 4 glasses of red wine at a friends birthday dinner the previous evening.

Next and latest bout was a week ago on my birthday. Same scenario on the red wine, but this time I didn't call the ambulance. Just went downstairs, sat upright on the sofa and the AF settled after about 40 minutes.

Possible factors:

Recent heart attack
Sotalol
Sotalol + red wine
Low heart rate at rest due to Sotalol (around 48 bpm)
I know I snore
My wife says that I occasionally stop breathing for a moment when I snore

I have also suffered from blurred vision since I got onto the full Sotalol dose and when I get into bed at night and lie down on my left side I suddenly become aware of my heart beating irregularly . This settles very soon after I turn onto my right side.

Can anyone make anything out of this jumble of information ?

I am starting to think along the lines of Sotalol plus sleep apnea ?

Well I am back. Seems that right after I posted mine I started having afib in my sleep. My BPAP has been sent off and so I m on a test unit again. So we will see what happens. It is 4am because I cant sleep. Im scared to go into afib with the apnea.

I am 43 years old, about 3 years ago I started waking up in the early morning randomly with my heart out of rythym. Repeated visits to the Cardioligist told me that my nightly glass of wine was doing this. So I did not have any wine. Randomly over time I continued to have this problem. We finally caught it by a heart monitor to confirm afib. My doctor would not burn a calorie to figure this out as I was afraid to sleep.
I changed doctors and got on a BPAP machine. Once it was regulated I have not had Afib in 1.5 years that I am aware of. It could possibly occur in my sleep as I have been awaken with apnea but with a couple of good breaths it straightens right out. With out a doubt I believe that if you stop breathing rythym for what ever reason, your heart can go into Afib. I carry my BPAP with me everywhere we go if it is over night and have not missed a night without it. Now the real question is how we can figure out why this occurs and get off of the bipap's. I m only 6'2 and weigh 197 which is considered slim for my height. I think weight does have something to do with it and exercise too. Stress was a huge part at the time mine was acting up. If I feel that it is skipping I take a 1/2 xanex or a 1/2 toprol. But I do not regularly take them. Hope this helps somebody.

I have both Sleep Apnea (due to my tongue blocking the airway while I sleep) and A-Fib.

I have not been able to be treated for my Sleep Apnea. I have tried every type of mask possible and it is too painful for me to keep it on my face. I end up crying and pulling it off my face. The people that test it says that it can not be loosed any further. I have tried a mouth guard and keep choking on my own flem. My Sleep Apnea physician sent me to a surgeon who said they can do one of two types of surgery. They could cut my tongue (as it supposed is too long) to correct my Sleep Apnea or they can do surgery in the nasal area. The surgeon himself said that they do NOT recommend either of these surgeries but that they can certainly be done.

My Sleep Apnea physician then suggested weight loss surgery, but I am being honest with myself. I know I could never keep to the type of diet one would have to committ to. As it is I have the worst diet possible: FAST FOOD as I find it to difficult to cook at home (I live alone and can't afford anyone to pay for it). I am also not eligible for home care.

I am treated for A-Fib but itje treat,ment does not correct it. I take Atenelol and Digoxin. My doctor has been having me take a full strength asprin rather than Coumadin. I told him that I preferred Asprin as I don't want to have to go through all the blood tests that would be needed. I am in CONSTANT A-FIB but I do not feel it.

I am seeing my Cardiologist this afternoon and going to ask him about
Electrical Cardioversion, Catheter Ablation, and Surgery and the likely hood that these treatment might help me. I am only 46 years old.

Jpat,

Thanks for your kind words about this site. And thanks for bringing up the point about CPAP tubing cleanliness.

While this blog is focused on afib, not CPAP (I love http://www.cpaptalk.com for that), that is important info. The instructions that came with my machine said to rinse the hose and hang it to dry every day, along with cleaning the mask daily and the filter weekly. Also to change the humidifier water daily (and clean with vinegar water weekly), or just use distilled water, which I do. CPAP cleanliness is very important.

Congrats on your success with the mouthguard and surgery. The opinions and experiences I've heard lead me to suspect that they work best for those with mild sleep apnea, and for some who have moderate sleep apnea, but not all, and generally not for those who have severe sleep apnea. This is strictly conjecture based on anecdotes froms others.

We're each different--an experiment of one--so what works to convert one person likely doesn't work for another. For me, oxygen actually has been known to convert me. It's possible that the CPAP might for you. It's worth a try.

Just as an FYI, for further research, we have brought together a lot of links on apnea here:

Sleep Apnea Multiplies Risk of Arrhythmias Like Atrial Fibrillation

In addition, we just published a story yesterday on sleep apnea's impact on catheter ablation (it's not good):

Severe Obstructive Sleep Apnea Predicts Atrial Fibrillation Ablation Failure, New Study Says

Good luck.

Mellanie

Hi Mellanie,
It is so nice of you to provide this forum for better understanding of what can be a serious health issue.

I have a mild form of sleep apnea and have been on CPAP (setting #8) for a bit over 5 years. I swear by the machine (ResMed S8 Escape II) and have had a relatively easy time with the mask. Recently, I went to the nasal pillows and find it preferable to the mask. The key is to use the right size pillows. The pillows are overall less apparatus on the head and just basically more user friendly for me. I have even quit using a chin strap. One big plus of CPAP is the idea of breathing filtered, moist air all night. I live in a dry climate and it just makes life easier here.

I have had a couple of recent episodes of A-fib and A-flutter. Thinking there might be a connection, I inquired of Google and sure enough. I hope to learn more about that connection in the future, but wanted to mention something I didn't see on your blog. Namely cleanliness of the CPAP tubing, humidifier, etc. and the air filter. I have noticed that I tend to yawn during the day when I have either an old filter or haven't cleaned my CPAP for much over a week.

I plan to ask my sleep doc about this, but suspect there may be a tie to the A-fib. As you know, yawning during the day is indicative of either undiagnosed sleep apnea or CPAP equipment that isn't working optimally. I have learned to reassess my program when I find myself yawning. Invariably, I am out of balance on something that is easily corrected.

I would like to add that I use a dental mouth guard that not only keeps me from grinding my teeth, but also encourages me to breathe thru my nose. I once had sinus infections and sinusitus but after endoscopic sinus surgery about 20 years ago I no longer have this complication. This is same-day, outpatient surgery that was a godsend.

I have been heading for the ER when I have A-fib, but believe there may be a better way to cadriovert myself. I've heard that straining, bending over and straining, jumping jacks, going to sleep with CPAP, etc. all work: but, would like to hear what works best and is safest.
Jpat

Paul,

I hope the CPAP is working for you.

I believe, from what I've heard, that afib with hypertrophic cardiomyopathy (HCM) is a very different "beast". Because of that, we have created a special interest forum in our discussion forums for those who want to discuss the unique challenges of afib and HCM and help each other.

You'll find it here:
http://forum.stopafib.org/

You'll be asked to register at the forums in order to post and discuss. I hope it's of use for you.

Mellanie

Jo,

Has it been 7 years since the last sleep study/titration? Has anything changed that could mean that your CPAP pressure setting is no longer optimal and that your sleep apnea is not as controlled as it had been?

Mellanie

Judy,

That's interesting that the CPAP seems to bring you out of afib. Though I've never heard anyone else mention it, it's quite likely that CPAP could do that.

I agree about not giving up. It seems that some DMEs don't know how to help folks pick out the right things and just provide "standard" gear without taking into consideration each individual's differences and needs. I think that's responsible for a lot of CPAP "failures". I wish there were a better way for those with sleep apnea to get exactly what will work best for them. If anyone has "cracked the code" on that, I'd love to know.

I decided to do a huge amount of research before ordering equipment, using online CPAP resources and discussion forums. I spent hours reading reviews of various machines and masks. One particularly helpful resource, at CPAP.com, has you take several facial measurements and recommends which masks will work well for your facial structure.

While I swore I wouldn't wear a "Darth Vader" mask, and preferred nasal pillows, I soon discovered that for those of us with sinus issues, and thus occasional mouth-breathing, full-face masks are really the best way to go. I tried a nasal mask, too, but ended up returning it (I'm glad I took out mask insurance on it). I also have a hybrid mask, which covers the mouth and has nasal pillows; I bought it for travel since it's much smaller than a full-face mask, but I just don't use it as it feels like having a blowtorch up my nose all night.

We're each different and have to find what works best for us. I encourage anyone who is struggling to research options as the right combination is out there, you just have to find it.

Thanks for your comments.

Mellanie

Scott W,

Good luck getting the sleep apnea under control. Some doctors have started not doing procedures until the apnea is under control as uncontrolled sleep apnea can cause a reversion back into afib, even after procedures.

I hope they can figure out how to manage the sleep apnea and get rid of the breathing pauses.

Mellanie

Hi Mellanie:
Thanks for your website.
I was diagnosed with mitral valve prolapse and afib at about 22 years old. It occured a few times a year, controlled then by inderal only as needed. Later, occurance got a little more frequent, so started minimizing caffeine and other obvious triggers (eg., dehydration, alcohol). At 49 had ablation by catheter which kept me out of afib for 4 years. I was feeling some extra heart beats recently, so my cardio doc had me wear the holter monitor. No afib, but he noticed heart stopped at night for 3 to 4 seconds. Had me do sleep study as he suspected i may have apnea. He was right: moderate apnea. Next sleep study was to calibrate PAP with mask, which i really didnt mind using, but the CPAP had to be to high - so they switched to BiPAP. With that, I quit breathing for over 90 seconds and the sleep doctor said i briefly went into afib or similar arrythmia. I think the machine rhythm threw off my breathing rhythm. I decided to not use PAP. A couple of weeks later I went into afib. I dont know if the event with the PAP precipitated it or more likely the caffeine in the chocolate I ate that day, duh. Electrocardiovert did not work, but sotalol did in 24 hrs. My cardio said we could stay on medication, consult the ElectroPhysiologist , or change lifestyle to zero caffeine, very little or no alcohol (a glass of wine only a couple times a week) and see what happens. It was ok for two and a half months, but then I went into afib again. They were going to E-cardiovert me, but the Soltalol finally converted me before the cardiovert appt, altho it took 4 days, this time. I really try to avoid triggers, but I am considering having ablation enhancement or touch up and have called my EP for an evaluation.

I respect my doctors who are ready to help me right away and relate to me what the latest info is. In particular, my cardio offers 2 or 3 choices to proceed and what the risks, pros, cons of each are. I decide, but he gives nudges as to which way(s) he thinks are optimizing. I think i am now going to have to deal with the sleep apnea issue further. I was surprised to learn that i have it. I fall asleep in a few minutes and rarely if ever wake up until it is time in the morning. I used to feel more refreshed when i awoke, but now i dont so much and about mid-afternoon feel tired. Maybe this APAP you mention might be what i need. During the test with PAP, there were some occurences of central sleep apnea, so i think my sleep apnea situation may be complex. I have several aquaintences who use CPAP and BiPAP with no problems.

Anyway, best wishes to you all and just keep at it and I enourage you to confer with your doc(s) to ascertain the best path(s) you can take. After afib-free several years I thought the ablation was a cure, but it seems we are back to managing it for now and that's ok, because we can be grateful for the opportunity and tools to manage the issue.
Thanks,
Scott

I have been using CPAP for sleep apnea about three years now. I was diagnosed with AFIB in Jan. 08. Several here have said they go into AFIB at night. My experience is just the opposite. I go into it during the day, usually afternoon or eve. but always wake up the next morning back in normal rhythm. I had been wondering whether ir was the sleep itself or the CPAP machine that converts it back. I am currently doing this four or five times a week and it happens this way consistantly.
About CPAP, please don't try just one type machine and give up. I have read lots of comments on sleep apnea site. Everyone seems to have a different choice on what works best for them. I Started with mask over just nose, could never get it tight enough to stop leaks unless it was painfully tight. I called it an "instrument of torture". Then I tried the nasal pillows. For me, that was the answer. Most of the time now I forget I have it on.

I have used a cpap machine for 7 years at least. This last fall-2008- I started to go into afib once a month. My doctor put me on cartia, and until May 2009, this seemed to keep me out of afib. Now I have gone into afib for 4 nights in a row- I wake up with rapid fluttering, can;t find my pulse, feel dizzy. Usually within 1-2 hrs it reverts. I am worried about the reasons and the long term effects. I take an aspirin when I wake up, and sometimes another cartia pill.

Hi -
I am 52 years old and in relatively good health. I have been diagnosed with Hypertrophic cardiomyopathy since i was 28. Also, have had an irregularly irregular heartbeat for years. Have been on beta blockers and had a pretty easy life. The new twist is afib. We think it started about 6 months ago - I stay in it all the time. Started Coumadin and they increased the atenenol - was not easy to tolerate the new dosages (lethargy and weight gain), but that is much easier. Had the first elcectroshock and went out of afib. Lasted four days and been back in it for another four weeks.
Yesterday the results of a sleep study said I have sleep apnea. So now something new to start - do not want this CPAP - but will give it a try. See how this works now - see the top guy at UCSF in a week and see what is next. Tell me it gets better.

I am 49 and have had a series of very mild afibs, always starting at night. I can get out of it by doing jumping jacks.

I have also been diagnosed with UARS, a lighter version of sleep apnea, but it has the same effect on distrupting sleep architecture.

I have started with the CPAP mask, and don't mind it too much. I am hoping that this prevents future afib episodes but am a little discouraged after reading some of these posts. Seems CPAP is not a cure over time. I would love to hear if anyone cured their afib with cpap...but I somehow doubt it.

It does seem that sleep apnea related afib responds less well to ablation. That said, Dr Warren Jackman thinks he has discovered a pathway which if ablated can help this specific form of afib. See article posted after the Boston Atrial Fibrillation Symposium 2009. Provides some hope.