Hello -
My first post! Question to others here experiencing paroxysmal AF, has the use of a CPAP for sleep apnea been enough to stop triggering your AF episodes?
My cardiologist thinks sleep apnea is the trigger for me (sleep study confirmed I have mild apnea). It's been a long journey to this point and since I've been using the CPAP machine at night I've most recently gone 25 days without an AF episode -- the longest period so far this year for me.
Trigger or cause? A trigger results in an episode of AF, a cause is why you have paroxysmal AF. I don't think they know what actually causes people to develop AF. They just know what is frequently associated with developing AF e.g. high blood pressure, sleep apnoea, diabetes etc but having any or all of the known risks factors doesn't mean you'll get AF. Similarly, eliminating a risk factor doesn't necessarily "cure" AF but it might (or might make it go away but come back later in life).
Sleep apnoea is believed to be a risk factor for developing AF i.e. potential cause. So is being overweight, directly and indirectly. For some people, losing weight has reportedly resulted in preventing further episodes of AF but for others it reduces the burden rather than eliminating it.
If sleep apnoea is a trigger, you should be able to link episodes of sleep apnoea to subsequent or concurrent episodes of AF. If it is a trigger then resolving sleep apnoea should prevent episodes that it would have triggered - but doesn't mean episodes won't be triggered by something else. That's why identifying your triggers can be difficult.
We're all different - so what works for someone else may not work for you and vice versa.
Thank you for the detailed response and for helping me to look at the issue in a different way. Great advice that's appreciated.
Unfortunately, last night I woke up to another episode while using my CPAP. 70% of the time episodes begin while I'm asleep and this is the first time I've had one since I've started using a CPAP. I'm experiencing positive results from the CPAP --it brought my sleep apnea events/hour rate down dramatically. This was not the development I'd hoped for☹️ and I guess it answered my question to the group. Wondering if I set it in motion mentally??
Fortunately, I don't have the other risk factors mentioned (high BP, diabetes or overweight) and realize I may not have as severe of case as others. I have researched causes and track my food, alcohol, caffeine, sleep, stress, exercise in an effort to isolate triggers but can't identify any. I've read paroxysmal atrial fibrillation eventually gets worse so I'm trying to be proactive.
There are many more risk factors for AF. I only mentioned a few examples.
The challenge of identifying triggers
There are so many variables affecting us at any point in time preceding an AF episode that it is difficult to identify triggers with absolute certainty. We focus of the ones we are aware of but there are probably many more, a lot that are probably outside our control.
I personally believe some or even most of my episodes involve a combination of factors, which further complicates pinpointing triggers.
I also believe the quantity of a trigger is a factor e.g. Alcohol is commonly recognised as a potential trigger for AF episodes. However, I can drink alcohol and not have an AF episode. Why? Presumably I need to have enough to affect my heart and logically, that will be affected by how much I drink, whether eating with drinking, etc.
Focusing on alcohol alone also doesn't take into account the potential impact of other possible factors drinking might combine with to trigger episodes e.g. stress levels or whether I'd slept well the night before or how much coffee I drank that morning etc how long since I took my medications (levels fluctuate during day) etc.
My aim in trying to identify and manage my triggers is to reduce my episodes. Expecting to totally eliminate them will, in most cases, only lead to disappointment.
Reducing your AF episodes is a win so celebrate your wins and don't get too down when the inevitable occurs. The glass is half full!
Are you sitting upright? This has helped me. Also I only sleep on my left side now.
Yes, I do have a slight incline in my mattress configuration and also use pillows to accent that. Not sure yet if that is helping me since I haven't been using it long enough, but glad to know it's helping you.
I formerly slept on my right side, my back, and my left side. However, I find it difficult to sleep on my sides when wearing a mask since it increases my air leaks so I now sleep mostly on my back so that mask stays in place. I recently purchased a pillow designed for CPAP users with a cut-out for a mask, which I'm still getting acclimated to but hopefully allows more side sleeping.
That was an excellent post - thank you. The often repeated phrase, "we are all different", always, makes me wonder since most of us end up with precisely the same treatment (beta-blocker + DOAC, fewer with with the likes of sotalol or flecainide).
I've come to think that the cause of AF is pointing either to a genetic predisposition in the atrial cells or changes in the cells brought on by very long-term lifestyle related inflammatory changes (and why they happen might also be genetic). I was surprised to read recently that so much remains unclear or unknown, for example, how beta-blockers or statins work and why some get HF. There seems to be a lot of work going on, though, which is a good thing.
Steve
Thanks Steve
Your thoughts re the most likely causes of AF (genetic predisposition combined with lifestyle/environmental impacts) make sense to me, for lots of reasons.
The similarity of drug treatments despite our differences highlights to me how primitive the treatments still are. Don't get me wrong though, I'm grateful to have the medications I do. I'm probably one of the luckier ones when it comes to medications. To date they have been quite effective and side effects have been negligible. However, that's not the case for a lot of people..... because "we're all different".
Well said. I’m lucky with side effects in general, too, thankfully. I’ve written a few times here that, regarding treatments, one day in the future, doctors might say about ablations, “Pull the other leg! They did what!?” 😉😳
Steve
Hi,
I see you are a new member, and I suggest using the Search 🔍option at the top to find previous Posts & Replies about sleep apnea. Lots to read. To save you the trouble, here's a link to the results ...
Hi thereI have been a CPAP and now a BIPAP user for 27 years because of sleep apnoea and a partially paralysed diaphragm
I also have PAF
Because I have been using the apnoea treatment for so long. Longer infact than I have been experiencing PAF I can't honestly say if one effects the other but I do suffer with both and my PAF episodes are getting more frequent.
Not sure if that helps but it is also known that sleep apnoea does put a strain on the heart so even with treatment I'm not sure if the heart is still under any strain.
Stall well.
monitor your sleep with a device like the O2 ring. (About $150). It records your sVO2 percentage and heart rate as you sleep (as well as motion). Can print out record if you choose through your smart phone I use my iPhone
I’ve found this extremely useful
Also be certain your blood magnesium and potassium levels are in the high normal range. That made a tremendous impact for me.
Thank you for the reply LowT. I agree with your excellent advice and have a Samsung Galaxy 6 watch that monitors my blood oxygen levels and heart rate. Track it closely, maybe even too much and thought about getting the O2 ring to confirm readings but maybe that's excessive?
I assume you are on medication for the AFib.
Just low dose 81 mg aspirin that my cardiologist prescribed.
What complicates things is I have bradycardia (when not in AFIB!) so cardiologist doesn't want to immediately prescribe meds to slow heart rate.
I also have bradycardia. Usually low 40’s while sleeping. Even to 37-39 rarely.
Ejection fraction is good so cardiologist not concerned (even to 35)
My afib is well controlled with propafenone, magnesium and potassium.
Very similar to my sleeping heart rate, last night was a low of 39 but low 40's is typical.
I currently take 400 mg/day magnesium. However, for potassium I will try to eat another banana daily and add a low dose of potassium supplements, Thank You for that suggestion!
Good to know your propafenone is helping - does that mean you haven't experienced any reoccurrences?
I take 200 mg elemental magnesium three times a day in the form of Mg citrate and 20 meq of Potassium Chloride three times a day. And 225 mg Propafenone three times a day.
Also wear WATCH to capture any irregularities feel which is rare now
I’m also swimming 1/2 mile three times a week. Not bad for an 83 yo guy
I am one of the 50% of people who is acutely aware of any arrhythmia such as premature atrial contractions or AFib so can capture on watch. Rare to have any of these.
BTW bananas can be fattening!
I wake up in the night with af I wonder if it's because of sleep apnea my cardiologist asked if I snore my partner says not very often but I always wake up with af in the night when I do have episodes how did you find this out ?
Not sure I understand the question?
My watch tracks snoring (length and time) but now when wearing a mask I don't snore. My watch vibrates a notification whenever I start to AF. I keep a log on EVERYTHING each episode in an effort to determine my triggers. Sadly, still coming up empty on that so far but will keep at it.
Exercises to reduce sleep apnea 
Sleep apnea results 
Bradycardia, sleep apnea and now AFib
Sleep, Nausea Headaches and AF
sleep apnea and afib
