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Sleep apnea, increases the risk of atrial fibrillation?

January 1, 2018


Atrial fibrillation is among the possible complications of obstructive sleep apnea syndrome. This common sleep disorder may therefore increase the risk of developing one of the most frequent forms of cardiac arrhythmia. This was confirmed by research from the University of Ottawa (Canada) presented at the last congress of the American Thoracic Society. This syndrome is «closely correlated with cardio-vascular diseases, in fact it involves a higher incidence of arterial hypertension, heart failure, heart attack and strokes», says Dr. Alessandra Ibba, pulmonologist at Humanitas.


The obstructive sleep apnea syndrome (OSAS) is characterized by frequent interruptions of sleep due to the “closure” of the upper airways that do not allow for proper breathing. In the research, the team examined data of 8,256 adults with an average age of 47 and with suspected sleep apnea syndrome. None of them had received a diagnosis of atrial fibrillation, but 173 of them then developed it during the thirteen years in which they were followed.


Among the signs of obstructive sleep apnea syndrome, researchers considered the number of times the patient stopped breathing while he slept and the levels of oxygen saturation, meaning the amount of oxygen in the blood. The latter has emerged as the most important predictor of atrial fibrillation risk. And the association was stronger in women than in men.

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Why does the syndrome increase the risk of fibrillation?


«We must think that in patients with sleep obstructive sleep syndrome the repeated episodes of “closing” the airways, can cause a reduction in the amount of oxygen in the blood, an increase in carbon dioxide, which is not eliminated as it should, causing constant changes in chest pressure» Replies Dr. Ibba. «These conditions, present in most cases for years, sometimes for decades, would cause dilatation of the left atrium on one hand, and an altered activation of the nervous system, favoring the onset of atrial fibrillation, on the other. We also remember that OSAS patients are mostly obese ones, and obesity in turn is associated with the development of arrhythmias».


This is why early diagnosis is important: «It is clear how properly diagnosing and treating the disease is essential to prevent its onset. In mild cases it is important to implement behavioral measures (weight loss, abolition of alcohol intake and sedatives); while in moderate and severe cases, those measures should be combined with Snight-time ventilatory treatment (CPAP)», concludes the specialist.

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