Did anyone here know that Sleep Apne... - Atrial Fibrillati...

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Did anyone here know that Sleep Apnea can cause AF?

Billybobjo1234 profile image
51 Replies

hubby has had AF for 3years.not really doing well. Originally it was off and on. Didn't see a consultant for 2years as he had left for Machester(UK)Cardiology. Finally it all came to ahead and has had 1 ablation (failed) in May 2022. Put on amiadarone till next ablation August (2022). That failed due to blood clot in appendage. Now on Digbox and Pradaxa till 8 weeks to check clot has gone and then attempt 3rd ablation. In the intervening months and after last ECG it would seem he has AFIB, A Flutter and Tachycardia. The idea was to sort both AF out then go through his heart from right to left and fix Tachy. Anesthetist came to see him after and said he thinks he has sleep apnea which can cause AF. So reading up on SA and read that using a cPap machine can actually reduce your AF by 42%. If this is the case why don't they test for SA and try that route before shoving so many drugs down people?surely that is cheaper?none of the drugs he has been on have reduced his AF he has grown to live with it but doesn't want to.anyone else on a cPap and can tell us if it works?

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Billybobjo1234
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51 Replies
Jalia profile image
Jalia

Yes, it is quite widely known that Sleep apnoea can contribute greatly towards AF . There are many on this forum who use a CPap machine and no doubt will come forward to give you advice.

BobD profile image
BobDVolunteer

Well known thing here and often mentioned.

Hi Billybobjo1234,

I can't comment on cPap, nor sleep apnea .... fortunately I have no experience. But I'll make a broad brush comment on your Q "why don't they test for SA and try that route before shoving so many drugs down people? " ............ A ....well for much the same reason as they don't investigate to any great degree how foods/food ingredients/ hot and cold drinks are not investigated in their relationship to the vagal nerve as triggers for AF ........ why would you ... NOT money spinners !!

How many of us have seen a profit and loss account, or a balance sheet of a GP practice, certainly in the case of mine it is lost in the financial make up of a company owned by a group of (local )medical doctors ........ what I'd be look for is revenue earned from pharmaceutical organisations/manufacturers for using/promoting their drugs.

All part of the changing face (to force peeps to go private ????? ) of 21st. century NHS.

My best wishes to you both in your AF journey.

John

belindalore profile image
belindalore in reply to

Profit over patient. You are so right. Poor healthcare is the other world pandemic....

Threecats profile image
Threecats

Hi Billybobjo,

CPAP user here😊 I was diagnosed with paroxysmal AF last year after a couple of A&E visits. Following the second one I had a phone consultation with an NHS EP who said I would be put on the list for an ablation and was also given Bisoprolol to take daily. I wasn’t keen on either option, as I felt that was dealing with symptoms rather than the root cause, so decided to do my own investigations.

All my episodes happened at night and I eventually found out I was getting regular oxygen drops during the night, so I had a sleep study carried out on the NHS in January and that found I have mild sleep apnoea. I’ve been on a CPAP machine for some months now and, after a rocky start I’m now using it 6 hours a night. Whilst I don’t want to tempt fate, since using it for the whole night I’m happy to say it’s transformed my AF. I’ve gone from having several episodes a week over Christmas to now not having had a full blown episode at night since using the mask. The only two I’ve had followed on from having nightmares ( suspect the Bisoprolol is causing that!) where I’ve woken with a start but 10 minutes of slow breathing and talking myself down I’ve gone back in NSR again.

I know this AF lark is a variable beast and I’m not saying it will never return but I can say that CPAP therapy has made a big difference to me, for sure.

As for your question , I do think it may be the case that some EPs are focussed more on what they’re trained to do, ie ablations rather than looking at the wider picture and possible causes.

I hope that’s of some help and I wish your husband well on his AF journey.

Billybobjo1234 profile image
Billybobjo1234 in reply toThreecats

Thank you that's encouraging. This whole saga has been a nightmare and hubby has the complication of a kidney tumour (Dr is 90% sure it's a tumour but won't do a biopsy due to its location and his heart). Now the EP anesthetist said he's very happy with his heart function but he wouldn't be there to do for his kidney out after urology dr said he wouldn't survive the op! So confusing and frustrating! He is in constant AF now.

Threecats profile image
Threecats in reply toBillybobjo1234

It sounds like a very difficult and worrying time for you both. I wish you well.

gerickson021 profile image
gerickson021 in reply toThreecats

I had "mild apnea" too. I started to always sleep on my side and started taping my mouth. Apnea is gone now, my sleep monitoring device confirms. Mouth taping is really easy, lots of products but simply use medical tape and tape it vertically center of the mouth. CPAP seems like a last resort given all the hassles, cost and discomfort.

Threecats profile image
Threecats in reply togerickson021

Thanks gerickson, I do tape my mouth to stop leaks via the nasal mask. Unfortunately, side lying, left or right, is out for me as that triggers my AF. Have to say I never thought I’d get used to wearing a mask at night but now I’d be lost without it!

gerickson021 profile image
gerickson021 in reply toThreecats

Not sure my reply went, here is some info below. the CPAP forces mouth breathing, not optimal for health. The taping keeps the jaw shut at night so you can nose breath. tmjsleepsolutions.com/mouth...

Threecats profile image
Threecats in reply togerickson021

I’m sorry gerickson I don’t like to disagree but your statement that CPAP forces mouth breathing is incorrect. The mask I wear only sits over my nose, hence I tape my mouth shut to prevent air leakage. There’s no breathing going on via the mouth. 😊 On what information are you basing your statement? The link you added only appears to confirm the benefits of nasal breathing.

gerickson021 profile image
gerickson021 in reply toThreecats

My mistake, I was thinking its was the old machines.

Megams profile image
Megams

~Often wondered which comes 1st? Chicken or the egg?I went for years with undiagnosed sleep apnea - always thought my sudden attacks (middle of night) not having breath connected with genetic heart defect (ASD) which was not repaired at that stage - was about 34 years of age at time.

My GP didn't take me seriously when mentioning that I felt I stop breathing at night so self referred to Sleep Clinic + decided to change GP's.

Diagnosis - mild sleep apnea (stopped breathing 19 times per hour) & use CPAP with great success. That was 5 or so years ago.

Since post menopause I started to have PAF issues.

Went ahead with cryo-ablation PVI privately Feb 2022 as meds had awful side affects + Dilitizem just stopped working as can happen.

Ablation successful thus far :) :) albeit few bumps along the way as is the case whilst healing.

So in nutshell I still went on to develop PAF/atrial flutter despite being on CPAP altho in all fairness I had obviously had s/a for many years (as mentioned) prior to developing regular ongoing arrhythmia issues.

I often wonder what damage to my heart & brain may have ocurred over all those years whilst being undiagnosed with s/a - my late Father had it & told it can be inherited.

I'm still hope to reduce some more of my heart meds if possible in time.

Hope this helps in some small way.

Mugsy15 profile image
Mugsy15

I think my treatment plan after being diagnosed with AF is standard at UK hospitals, and that included a sleep study to see if the cause was apnoea, a major and very well known cause.

Billybobjo1234 profile image
Billybobjo1234 in reply toMugsy15

We never had a plan. Have had very poor follow ups and seen the actual Dr very little in fact new Dr never only in "the lab". Find it very worry this has not been suggested/followed up or even mentioned. He is under the care of Blackpool Cardiology and to be honest am not very impressed at all. To find just before the actual procedure he has a clot so it couldn't go ahead is absolutely ridiculous and then SA is mentioned this is 3-4 years after diagnosis. So his "standard" is not the same as elsewhere and this is mean to be the "flagship" cardiology Centre for Lancashire. I think I'm going to go through patient liaison about all this as I'm just not happy with it at all.

Threecats profile image
Threecats in reply toMugsy15

It certainly isn’t standard at the UK hospital I attended Mugsy! Sleep apnoea never got a mention, I only discovered the link through my own investigations once diagnosed with PAF!

dedeottie profile image
dedeottie in reply toMugsy15

I have never been asked about this either in Lancashire or Wales. I am pretty sure I do not have it though. I know people who do have sleep apnea and use cpap but non of them have AF. I do know that it is widely known that AF and SA are often found together so am surprised I have never been asked. On reflection I do think that I remember filling in a form way back in 2014 that asked about sleep. X

Mugsy15 profile image
Mugsy15 in reply todedeottie

That's the one. So it was part of your initial investigation. Despite what some have said it is standard to test for all the usual suspects after diagnosis.

Thyroid, diabetes, sleep apnoea, structural and/or historic cardiovascular issues, obesity etc.

If these tests haven't been done then I'd personally say treatment has been substandard.

Threecats profile image
Threecats in reply toMugsy15

Forgive me but I don’t think asking the patient to fill in a form is, by itself, a sufficient test for sleep apnoea, particularly if it’s mild/moderate.

Mugsy15 profile image
Mugsy15 in reply toThreecats

You're right, but the form is merely the first part of testing. If your answers indicate any of the classic symptoms of SA you will receive a phone call from a trained technician who will take you through a series of questions and assess your risk. Next step is to attend a sleep clinic. To come back to the OP's original query, SA is not only a well known cause of AF, it is part of the standard investigation post-diagnosis and has been for many years.

Threecats profile image
Threecats in reply toMugsy15

I agree with you Mugsy, in that SA is a well known cause of AF and checking for it should be a standard investigation post diagnosis. Unfortunately, this seems to be a variable practice across the country. As I say, it didn’t happen in my case at all and the OP’s husband appears to have had two failed ablations before the possibility of SA was mentioned. Sadly, like so many things in the NHS at the moment, it seems to depend on who you see on the day. As for the form, the problem is that, women particularly, often do not display the classic symptoms of sleep apnoea. In fact, the NHS sleep tech I saw explained that they employ software with a different algorithm when assessing female patients for this reason. Rather like the symptoms listed for a possible heart attack, the classic apnoea symptoms are based on how the condition commonly presents in men.

Mugsy15 profile image
Mugsy15 in reply toThreecats

Can't disagree with any of that Threecats. The definition of the word I chose: 'standard', is the only discrepancy here I think. I used it to mean 'widely accepted and practiced' rather then 'universal'. As we have seen in this thread, some hospitals would appear to be failing in their duty to properly investigate the potential causes of patients' AF, which brings me back to another term I've already used - substandard.

Ducky2003 profile image
Ducky2003

It was one of the first things mentioned to me when I was diagnosed with AF 6 years ago. I had a sleep test done and was borderline for sleep apnea. They gave me a cpap to try but I lasted about 3 mins before whipping the mask off as I hated it. As I was borderline anyway, I handed the machine back.

Threecats profile image
Threecats in reply toDucky2003

I know where you’re coming from Ducky! My first trial with CPAP via NHS was a disaster, too! It was only following several more episodes of AF after handing the equipment back that I realised I had to try again, so purchased my own machine. Thanks to the wonders of YouTube, I found out how adjust the pressure to get used to it to start with and now wouldn’t be without it! Never thought I’d say that!

Ducky2003 profile image
Ducky2003 in reply toThreecats

They turned the air to the lowest setting and tried me with the smallest mask but I still felt like I was hanging out of a car window going at 90mph (not that I've ever done that 😆).My Fitbit measures O2 fluctuations and they are normally in the low range so I'm hoping I'm still borderline or less.😁.

Threecats profile image
Threecats in reply toDucky2003

Wot, no hanging out of car windows at 90 mph for you?!! 😂 😂

Ducky2003 profile image
Ducky2003 in reply toThreecats

🤣. Not officially 😁.

frazeej profile image
frazeej

Just an anecdotal comment/observation: I think over here in the states, sleep centers/sleep apnea has evolved into a new cottage industry. 9/10 diagnosed with sleep apnea and came home with the CPAP machine (Medicare covered)! My wonderful (now retired) GP agreed. I asked once about sleep apnea, he asked if I was tired during the day. I responded, not until about 10:00PM. He said I don't have sleep apnea. End of "study"!

DawnTX profile image
DawnTX

I am waiting for the kit to have my Sleep Study at home. I was tested years ago and told I had sleep apnea but I ignored it. I did not read what you did but saw that it definitely affects a fib so I thought I would finally give him get the test and get a machine. I love what you wrote it makes me feel even better about doing this now. Here in the states they actually have a test kit they mail to you. It is nowhere as restrictive as the sleep study and a building was. No wires all over the place you can get up if you need to lol are usually need to about 3 AM. You do this for two nights. To see the numbers you posted about helping is fantastic. Thank you for sharing

Threecats profile image
Threecats in reply toDawnTX

Good luck with the home study Dawn. If you do get a machine I hope it helps you. It’s certainly made a big difference to my AF!

DawnTX profile image
DawnTX in reply toThreecats

Thank you for telling me that. I have a friend with one and I became aware that they have changed styles etc. now I cannot deal with anything on my face but with the new nasal cannula I can do that. I wake about every two hours always exhausted maybe I will finally be able to sleep again. I just needed the test so that my insurance will provide the machine. Those of you that spoke about it on here have made me feel sure I am doing the right thing. I also had a friend who lost his son in his 40s a few years ago to sleep apnea while watching TV so it can be deadly Thank you again

gerickson021 profile image
gerickson021

Depending on the severity of the sleep apnea it can often be cured by some simple hacks, sleep on your side, dont eat 3 hours before bed, tape you mouth (lots of info on the web about this). Worked for me.

gerickson021 profile image
gerickson021 in reply togerickson021

Hi, The CPAP machine forces mouth breathing. The mouth taping keeps the jaw from dropping open at night and keeps you nose breathing. You get more O2 via the nose and lots of other heath benefits. tmjsleepsolutions.com/mouth...

Billybobjo1234 profile image
Billybobjo1234 in reply togerickson021

Hubby does sleep on side and definitely no food 3 hours before. May try the gag!

gerickson021 profile image
gerickson021 in reply toBillybobjo1234

He could try the taping, they also make little devices to open then nose up too with the mouth taping. Lots of health benefits from doing this. Here is a smaple of one option: Densors Carecog Set of 4 Nose Vents - No Snoring - Ease Breathing - Nasal Vents - Anti-snoring

Billybobjo1234 profile image
Billybobjo1234 in reply togerickson021

Thank you will look into that. We are just so confused and frustrated!

gerickson021 profile image
gerickson021 in reply toBillybobjo1234

My experience is that doctors dont offer much health advice. You have to find out "health" options on your own. As an aside use any other search engine besides google when looking up heath related options.

Billybobjo1234 profile image
Billybobjo1234 in reply togerickson021

Why is that? Not google?

gerickson021 profile image
gerickson021 in reply toBillybobjo1234

Google,according to various "alternative" health websites say that google drops their information down to the last pages. Only the typical western med options like "WebMD" come up on the first pages. Started when covid appeared.

Threecats profile image
Threecats in reply toBillybobjo1234

Hi again , please be very careful if your husband does try mouth tape, it’s not suitable for everyone. I don’t know if your husband has any lung conditions, asthma etc but it would be contraindicated if he does. Please also note that Gerickson’s comment about CPAP machines forcing mouth breathing is incorrect!

Billybobjo1234 profile image
Billybobjo1234 in reply toThreecats

No he doesn't and I wouldn't dare tape his mouth without medical advice. I've seen the retraction on that response too thank you. I remember now his previous EP did ask about sleep apnea but never followed up with any tests then he left for bigger hospital and hubby has clearly slipped through the net. Now only being followed up after 3 visits to ER to get something sorted.

gerickson021 profile image
gerickson021 in reply toThreecats

yes, sorry about the mouth stuff, old info.

DawnTX profile image
DawnTX in reply toThreecats

I am glad you said that because I just realized the same. I am a mouth breather and that is my problem. Sometimes I get so dry I wake up choking. I have been one since a child I remember the dentist saying that when he tried to give laughing gas.

Threecats profile image
Threecats in reply toDawnTX

You may not necessarily be, Dawn. Muscles relax when we’re asleep, as you know, allowing the jaw to drop and the mouth to open - hence dry mouth. Unless you have some physical problem with your nose that prevents you breathing through it at all, then relearning to nasal breathe, and using mouth tape, if appropriate, should enable you to get back to breathing through the nose, as nature intended. If you do have a problem with nasal breathing then you would need a full face mask but that’s not as daunting as it sounds, honest!

DawnTX profile image
DawnTX in reply togerickson021

I think I’ll leave it to the professionals to help me with this especially if it can help my A fi is well.

Shmediac profile image
Shmediac

When I was diagnosed with Afib, my cardiologist mentioned SA, so he set me up with a lab, and I went and brought home a device to wear at night ( 1 or 2 nites, cant remember), they did a study on the results and said I had moderate SA. I got a CPAP machine, was not easy to get used to, but eventually I did.Had to experiment and find the right mask. I didn’t know I had sleep apnea, wasn’t always tired or anything. They say it helps with Afib, having a machine, but I can’t tell, because I had an ablation 3 months ago, and am feeling good. Will continue with the CPAP though.

TM93 profile image
TM93

To my knowledge there isn’t strong data supporting that theory. My case was just the opposite. My doctor insisted I have a test for sleep apnea but I refused because I know that I don’t have it. Now that my Apple Watch checks my oxygen level I have proof that I am correct. However, that doesn’t mean that sleep apnea doesn’t play a role in AFIB for some individuals. There just isn’t conclusive data and from what I have read the studies that have been done we’re not completed by nonpartisan researchers.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiYes.

The Chemist's hubby finally went to a private special and I went to him afterwards. My priv diagnosed sleep apnoea.

Me he started me in CCB Calcium Channel Blocker and immediately I was controlled after 2 years 3 months and 2 drugs under first a Dr on. Stroke Ward and then at 1 year 6 months a DHB pubic hospital heart specialist.

CCB took me down 105 H/R in 2 hours. To 51 day. After twinking between ManageMyHealth I am now on 120mg Diltiazem 120mg am and 2.5mg Bisoprolol pm.

BP 123/72. 77-88 H/R avge day rest and 47 Night. 24-hr monitor.

My priv specialist was interested like my Locum Dr.

Cheri. JOY. 73. (NZ)

Keibval profile image
Keibval

Well YES. …….. I was told I have sleep apnea about 20 years ago …..was in hospital having surgery on my knee …….was TOLD TO TELL MY GP. Which I did …….no response … few years later having hysterectomy was told by senior nurse that I have sleep apnea and TOLD TO TELL MY GP which I did again …moved house and 16 years later TOLD GP …….and was found to have AF ……….saw the consultant who said “ we will refer you to a sleep clinic” ……that was 6 years ago……….?????????? have told several nurses and even my orthopaedic guy …..but no one seems interested ! I guess it is a postcode lottery / money thing ….but would have thought the treatment would lessen the costs long term ? But what do I know ? 🤔😵‍💫

Billybobjo1234 profile image
Billybobjo1234 in reply toKeibval

Exactly my thoughts. I have now raised a complaint through PALS as not happy with my hubbys progress or lack of it!

Madscientist16 profile image
Madscientist16

In the US, many EPs' will not perform an ablation until a sleep study is done; and this for everyone.

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