What is Atrial Fibrillation?

Atrial fibrillation (AF) is an abnormal heart rhythm where the upper chambers of the heart beat irregularly and often rapidly.

Symptoms may include:

• Palpitations
• Breathlessness
• Fatigue
• Dizziness
• Reduced exercise tolerance

AF is associated with an increased risk of stroke, heart failure, and hospitalisation.

How Are AF and Sleep Apnoea Connected?

Research has shown that up to 50-80% of patients with atrial fibrillation may also have obstructive sleep apnoea.

During an apnoea:

• Oxygen levels fall
• Carbon dioxide rises
• Blood pressure increases
• Stress hormones surge
• The heart experiences repeated strain

These changes can trigger electrical instability within the heart and contribute to AF development.

Why Sleep Apnoea Makes AF Harder to Treat

Patients with untreated OSA are more likely to:

• Experience recurrent AF episodes
• Require repeat cardioversions
• Have poorer outcomes after catheter ablation
• Develop progressive heart disease

Many cardiologists now routinely recommend sleep assessment for AF patients because treating OSA can improve long-term rhythm control.

Why CPAP Matters

CPAP therapy helps by:

• Maintaining an open airway
• Reducing oxygen desaturation
• Lowering sympathetic nervous system activation
• Reducing blood pressure stress
• Improving sleep quality

Several studies have shown CPAP-treated patients have lower AF recurrence rates compared with untreated patients.

What Happens if OSA is Diagnosed but CPAP is Not Used?

If a patient with both AF and OSA chooses not to use treatment, they may experience:

• Ongoing oxygen desaturation
• Continued strain on the heart
• Higher rates of AF recurrence
• Increased stroke risk factors
• Reduced effectiveness of cardiac treatments
• Persistent fatigue and reduced quality of life

While every patient is different, untreated sleep apnoea is recognised as a significant contributor to ongoing cardiovascular risk.

Key Takeaway

If you have atrial fibrillation, assessing and treating sleep apnoea may be one of the most important steps you can take to support your heart health.

At Sleep Dynamics, we believe that understanding the connection between sleep, heart health, respiratory health, and overall wellbeing is essential to achieving better health outcomes for our communities.