Sleep Apnea and afib

[sealover]

Greetings across the pond........I'm 81 and have been dealing with afib for 11years. I had my first ablation 2 weeks ago and was back in afib 4 days later. Today I had a cardioversion which was successful; and of course, I hope it lasts. The team who administered the procedure reported that sleep apnea showed up during the cardioversion. Their opinion is that sleep apnea is a genuine problem that often contributes to afib. They observe this in many, many patients. I had given the cpap machines a good try; and I simply could not adjust to them. What other answers are there to this problem? I can't even imagine sleeping in a recliner chair for the rest of my life !! I so appreciate this site and am so grateful for all the knowledge and encouragement that is always offered. You have been a huge blessing to me. Kindness counts more than anything to those in need.

[Bagrat]

Hi Sealover, my husband has obstructive sleep apnoea and is in permanent AF. He has only had a cpap machine for 5 years. I suspect sleep apnoea has been around much longer. He has always been an amazing snorer. When in the RAF on detachment sharing a room the poor unfortunate sharing tried throwing pillows and eventually threw a drawer out of what you would call a night table I think!Fortunately as a pilot, he was used to wearing O2 masks so no problem. He does thrash about and the mask emits strange noises so we sleep in separate rooms.

There are many different masks available and it may be trial and error as to which suits. If you really can't cope there are various less intrusive snore reducing gizmos but none really impact on sleep apnoea as it is the air being pushed gently into your lungs, by the machine, when you have those gaps in breathing, that supplies the oxygen you need.

You wont stop breathing altogether with sleep apnoea as your body has a "fail safe" unconnected with your lungs directly. When carbon dioxide builds up in your blood, your brain is alerted and sends a message to the lungs to breathe. That's why with sleep apnoea you have those long gaps when you don't breathe

I do hope you find a mask which you can cope with

[Threecats]

Hi Sealover,

I too have sleep apnoea and AF and I agree with your cardioversion team that sleep apnoea is definitely an AF trigger. I often had AF episodes at night and wore a little gizmo that recorded my heart rate and Oxygen levels through the night to try and find out what was causing it. I saw for myself on one particular night how a drop in oxygen levels triggered a heart rate spike which in turn triggered an AF episode, so was left in no doubt about it! That’s also how I found out I had sleep apnoea.

I was formally diagnosed and given a machine by the sleep clinic. This was set to auto titrate. I was also given a full-face mask and, as it was during Covid lockdown, was left to get on with it. Needless to say I just couldn’t! I struggled for a month of being woken up all night with the machine blasting air in my face and then gave up on it and handed it back in.

However, a few months later I had a private consultation with a cardiologist. During that he explained the irreversible damage that sleep apnoea had already done to my heart and the further damage it could do, so I realised then I had to make a go of this CPAP business.

I purchased my own machine and mask and followed the excellent advice I found on two YouTube channels : TheLankyLefty27 and CPAP Reviews. I switched the machine to fixed pressure and set it to the lowest pressure setting, gradually increasing it over a period of weeks until I reached my therapeutic pressure. The problem with the auto titrate function is that it’s usually set for some crazy pressure range between 4 - 15 or even higher but the machine’s algorithm isn’t very clever and once it’s jumped to a high pressure it tends to stay there, so you wake up with the machine blasting air in your face at a suffocating level, hence the switch to fixed pressure which gives much more control. Also, in the early days, I used to wear the mask whilst watching television at night etc. just to get used to the feel of it on my face. Now, some three years later, I can’t sleep without it! Never in a million years did I think I would ever be saying that!

I apologise for the length of this reply, a positive essay I know but I would urge you to try again with CPAP and hopefully some of what I’ve written might be of help to you in adjusting to it this time.

Wishing you all the best, TC

[CDreamer]

I have SA and wear a CPAP at night which stopped all my nocturnal AF from day 1. I’m on my 3rd machine now having had one since 2014 so 10 years. I have NEVER slept in a recliner chair, not sure where that came from? Who on earth told you that?

I have a brilliant CPAP clinic who now check up on me twice a year - it’s fully monitored with a blue tooth link so the clinic can see how I get on if ring if they see anything unusual and if I run short of anything all I do is ring and they post me replacement parts - all on our NHS. I was NOT left to ‘get on with it’ and had 1 x 4 hour masterclass at the hospital trying all the different masks and getting used to the pressure and then 1:1 about 6 weeks later and would say that support was really important to how I persevered with getting used to wearing the mask and getting the right one for me. I wear a nasal mask, I couldn’t get on with the full face mask nor the nasal pillows so once I found the right one for me, it has been very helpful.

It’s absolutely brilliant and improved my QOL, alongside with my pacemaker. Like 3Cats I would urge you to try it but expect to take some time to adjust. We were advised to wear the mask for several hours during the day, when we could, just to get used to the mask first. I could only use the machine for a few hours to begin with, then 4 hours and now sleep soundly for 6-7 hours every night. A good night’s sleep makes all of the difference.

[secondtry]

I had/have mild sleep apnoea when they tested some years ago; not enough for the CPAP machine to be prescribed though.

I have tried to deal with this with a night time nasal strip and during the day doing breathing exercises to slow it down plus de - stressing generally.

I will find out if any of this has worked when I have another sleep test later this month and will report back.

I'm sure SA is a strong contributory factor for AF but for the most part over 11 years I have reduced its effect by working on other AF contributory factors to keep below the trigger threshold and stay AF free.

[kocoach in reply to secondtry]

I've been diagnosed thru a sleep study with severe sleep apnea about 5 years ago but I just can't handle the cpap machine and mask. One Dr I spoke with said sleep apnea occurs when you sleep on your back so he advised getting a t shirt and a piece of cloth and sew a tennis ball on the back so when you lie down you can't lay on your back only on your side. Needless to say I found a new Dr.

[secondtry in reply to kocoach]

I would welcome more discussion on this issue and the interaction with AF. Initially I found sleeping on the left side prompts AF (more pressure on a sensitive Vagus Nerve). Sleeping on the right side caused pre-AF feelings. Not comfortable sleeping on my stomach. So left with sleeping on my back propped up by more pillows.

No change on this arrangement for many years but I suspect SA is still there and hence having another Sleep Test this month. My wife and I sleep in separate bedrooms due to snoring and so unfortunately I don't get her reports on my breathing.

[Threecats in reply to secondtry]

Is that because you snore, Secondtry, or your wife? Whoever it is, it indicates a narrowing of the airway during sleep and possible sleep apnoea, doesn’t it. From my discussion with the respiratory nurse at my sleep clinic, I understand that CPAP therapy is now offered on the NHS even for mild sleep apnoea if you also have AF, as the link between the two is becoming better recognised. Good luck with your sleep study later this month .

[secondtry in reply to Threecats]

Both of us snore!! I agree narrowing of the airways main culprit. Useful to know 'mild SA' now qualifies for treatment 🤞this applies in Guildford, Surrey.

[Threecats in reply to secondtry]

Now that’s taking sharing a bit far😀

I can confirm mild SA plus AF qualifies for treatment in Guildford as that is where my respiratory nurse is based.

[secondtry in reply to Threecats]

Ha Ha ! That's great news, much appreciated 👌.

[bmand]

Hi so far you’re lucky the cardio version has lasted this long. The next step is ablation . I’m 80 and discovered that I had slept apnea. There are a large selection of mask available. Give another type a mask you’ll probably find one that works for you.