apnia and atrial fibrillation

[hegel]

After starting cpap therapy I experienced my first episode of atrial fibrillation. I've had two episodes since. I'm convinced that, if anything, my cpap therapy is helping me in terms of afib; in other words, I don't see a causal relation between the two conditions. Everything points in the other direction: cpap helps with afib.

Waking up with a racing heart is now a big deal for me; mine might not stop racing. Therefore I want to do everything I can to stop this from happening in the first place. Using cpap is my first line of defense. I just downloaded Encore to see how I'm doing but, also, to have a record in case I have another episode of afib. But Encore doesn't tell me my oxygen levels, as far as I can tell--although maybe this can be implied by how well my other indicators are doing. Also, of course, it doesn't measure my heart rate during the night.

I know about pulse oximeters and may get a cheap one just to satisfy my curiosity. But I can't wear one every night!

In short: I'm really just angling here for any comments/help with this issue. I'm assuming that low oxygen levels might be the precipitating factor in a racing heart--but no doctor has told me this--doctors haven't really mentioned my afib and apnea together at all--so I'm just intuiting here. (There may be no relationship between my afib and apnea, for all I or anyone knows!) But this is my working hypothesis. Best guess. Shot in the dark.

So do I need to be looking at anything in my Encore results that will tell me about how best to optimize my oxygen levels? My leak numbers are acceptable (but hard to interpret; I'm still new to this and going over them.)

Or does anyone have helpful info about this subject in general?
Thanks.

p.s. the only time I've seemed to wake up with a racing heart, I've been in full blown atrial fibrillation! So I don't think that this is common for me.

[Pugsy]

What machine are you using now? Your machine choice in your profile is for a PR S1 machine and your humidifier is for the M series.

If you have a PR System One machine you can use SleepyHead and a CMS 50 D Plus (or higher) pulse ox and put your Pulse ox reports into SleepyHead so you can see pulse rate (from the pulse ox) and Oxygen levels and see if there is any correlation with apnea events.

SleepyHead is compatible with the CMS over night recording pulse oximeters. Around $70 or so from the pulseoxstore where I got mine or a little cheaper from EBay seller in China.

[steveinmaine]

There is a definite link between sleep apnea and afib. As the Mayo Clinic says, "Studies also show that obstructive sleep apnea is associated with increased risk of atrial fibrillation."

I know this because my father's sleep apnea was diagnosed when he was first being treated for afib. He kept waking up in afib in the middle of the night, and so the connection seemed very clear to us.

Since he's been on CPAP, his afib has lessened a good deal, though that may well be from his medication. What we do know is that his sleep study showed 41 AHI, and that being on CPAP is definitely helping in keeping his apneas at healthy levels.

As far as what precipitates afib when sleeping, I'm not sure. The three or four times he's woken up in afib since being on CPAP, I've checked his card for that hour and haven't seen any correlation of any excess apneas. I'd be interested in hearing what you discover with your own readings.

Here's some links I found when researching their connection, and all the best with your sleep.

http://health.usnews.com/usnews/health/ ... 041007.htm
http://www.stopafib.org/causes.cfm

[hegel]

the cpap machine that I have listed came from the "pull down" which was offered by cpaptalk. I'm sure that it's "my" machine; mine says on the body Respironics remstar auto m series with A flex. I don't know if it's a system one. I thought that this machine could only work with Encore, not Sleepy head; hopefully I'm wrong...being able to correlate apnea events with a pulse oximeter would be very nice...although possibly technically challenging for me. Hopefully it's not even a regular issue, or an issue at all, but I'd like to know.

Steve, thanks for the links! My afib is idiopathic, which means that the doctors don't know the cause. Also, I have no underlying heart conditions, so it's lone atrial fib. Just a glitch in my wiring, perhaps. Mine always comes on at night (only 3 instances)so of course I'm looking at my apnea as a possible source. Afib is mysterious, not at all well understood. But there's definitely a correlation with apnea. Others on this forum have reported waking up with a racing heart, but not necessarily being in afib. I'm wondering if this sort of racing heart can precipitate my afib. And what causes a non-afib racing heart while sleeping in the first place. Again, I'm guessing low oxygen levels in the blood. Hopefully, others here will know!

Thanks for the responses!

[Catnapper]

Thanks for starting this thread. I know someone who just found out he has a-fib. I have been nagging him to have a sleep study.

Catnapper = Joanie

[Pugsy]

Click on the link you have chosen for your machine...look at it. Does it look like your machine?

If you have a M series humidifier..then you have a M series Machine and not the SYstem One because they won't go together.
Your machine in the drop down menu would be the
M Series Auto CPAP with Aflex
that link is broken though so if you choose that machine you won't see a machine in the drop down menu
When that happens we suggest that you manually add it to the comments section of your equipment profile...see how I have added that I also have a BiPap Pro in mine.

If you have a M series machine then the only software available is Encore. SleepyHead won't work.

We have people choose the wrong equipment all the time. It makes for giving advice a little difficult because we look at the equipment profile when we offer advice.
If your error had been in the humidifier choice and you really did have a System One (click on the link to mine and you will see the difference) then you could use SleepyHead.
When you told me in the past that you used the M series humidifier...then I assumed you used the M series machine because the two models won't work together. And that's why I told you that your only choice was Encore.
Then I see you choose the PR System One..and I wonder if your machine is wrong choice or the humidifier is wrong choice.
That's why I asked for the clarification.

I suspect this is your machine
https://www.cpap.com/productpage/remsta ... -flex.html

[old dude]

I don't know which is worse, A-fib or Atrial Flutter, but I do think they're closely related. I was diagnosed with A-flutter back in January when a routine BP check showed my resting pulse rate to be 186. Yes, you read that right, 186! The thing is, I felt no distress and could walk about and converse normally. At the ER they gave me a drug that supposedly shut down my heart briefly in the hope that it would mitigate the A-flutter, but it didn't work. I stayed in this A-flutter rhythm for roughly a month while my cardiologist tried other drug intervention and did all kinds of testing. The meds didn't help so he eventually did a cardioversion, which worked. He warned me that it might or might not come back.

Always looking for a cause and effect relationship, I pushed my doc for a reason for the onset of A-flutter-but he steadfastly refused to tell me much. I had (and have) a lot of the risk factors: overweight, 63 years old, high BP, like a little nip of red wine, and he suspected sleep apnea. He ordered a sleep study which was finally done in April, revealing an AHI of 131. The rest is of course history. After seeing the results of the sleep study he finally opined that he felt like sleep apnea was the most likely precipitating cause of the A-flutter.

As an opinion from one who is strictly a layman, I would think it is more likely that the sleep apnea helped precipitate your AFIB rather that the other way around. Those with real medical training can please correct me if I'm wrong.

I would consider myself lucky that yours seems to be paroxysmal (come and goes), rather than coming and staying like mine did.

[elessadil]

I was diagnosed with A-fib a year and a half ago. I would wake up in the middle of the night with my heart racing in A-Fib and I would have to go to the hospital and get cardio version to knock it back into proper rhythm. July of this year I was diagnosed with moderately severe sleep apnea. According to my Dr there is a definite relationship between the 2. The reason he sent me for a sleep test was because of snoring and exhaustion coupled with going into A-Fib while sleeping. He told me that sleep apnea puts a strain on the heart and this coupled with the decrease in oxygen can cause your heart to go into A-Fib. My A-Fib eventually got worse and can now show up at any time. Since I started xPap therapy I haven't had as many episodes and those that I have had have been less severe and I haven't had to go the hospital because my heart reverts after a few hours. I am hoping that the longer I am on xPap therapy the better the A-Fib will get and I won't have to go on blood thinners like warfarin. My mother is on that and she has to be super careful about what other meds she takes; even OTC meds.

A-Fib runs in my family....my mother has it and grandmother, great-grandmother had it too. I think my mother has sleep apnea, but she won't go and get tested. Says at her age (81) it doesn't matter. I told her it does and she should go, but can't persuade her. I believe that both my grandmother and great- grandmother also had it. They could both demolish houses with their snoring in between bouts of silence. It's too bad there is no way to check to see if they had.

GERD and hiatal hernias are other possible causes for A-Fib and I have both. You may have silent GERD - Silent reflux is acid reflux that does not produce heartburn or indigestion. You don’t know you have it. The most common silent reflux symptoms are hoarseness, chronic cough, throat-clearing, post-nasal drip, sinusitis, sore or burning throat, difficulty swallowing, shortness of breath, snoring, sleep apnea, bad breath, tooth decay, asthma, and COPD. Unfortunately, your doctor is probably unaware that these symptoms may be caused by silent reflux and that it could be controlled with the proper diagnosis and treatment.

Worth checking out. Maybe your A-Fib is not idiopathic after all.

[Sir NoddinOff]

Just a quick two cents about my personal experience with AF, before and after CPAP (ie. ASV). Before my current ASV therapy, I've found that when I had a rough night of sleep I would sometimes experience minor bouts of AF in the morning, in which case I'd skip making coffee/tea and I'd take it easy getting my day started. Later in the day after my heart calmed down I would try to get some mild exercise like walking or biking.

On the other hand, since I've been using my S9 Adapt ASV on a nightly basis, I've had zero AF and my AHI has basically been below 1.0 almost every night for four months. Like I said I never had AF in a big way before CPAP, however it is alarming to have your heart go all arrhythmic on you. BTW, my cardio doctor did Rx nitroglycerin pills for me, but they tended to make the AF worse, therefore I avoid taking them. EDIT: Thanks to the two previous replies that mentioned A-Flutter and Silent Reflux... didn't know about either one until now

[HoseCrusher]

Sleep apnea that results in a reduction of oxygen saturation damages the cardiovascular system. The body constantly is in the "fight or flight" mode and the hormones released from running out of oxygen need to be processed by the body. While they linger they do damage. Treating the problem with xPAP prevents further damage.

Many people with afib, including myself, have found that increasing the intake of magnesium greatly helps eliminate it. Organic green leafy veggies are a good source for magnesium and sometimes it takes a little more in the form of supplements. Be careful because too much magnesium has laxative effects.

My cardiologist and I have gone round and round on this and while it doesn't help 100% of the time it is relatively risk free. In my case straight magnesium works to eliminate the afib while a combination of calcium and magnesium doesn't. I should add that another side effect of magnesium is blissful sleep...

[Sir NoddinOff]

Another way to supplement magnesium, which I do, is to buy Magnesium Oil at any health food store. You spray a few shots onto your abdomen once a day and rub it in. It's not really oily but just feels that way until it dries. Your skin simply absorbs what it needs, that way no fuss about taking too many pills.

[hegel]

Pugsy: yes, the link that you posted is to my machine...but I have the heated humidifier as well. Looks like this is the older model that won't accept sleepyhead? So I posted the wrong machine on my profile; your response was correct according to the information that I'd given. Sorry for the confusion. I'm slowly learning that there are "subtleties" to masks and machines that need to be appreciated. My profile should be updated now.

Thanks for all of the responses. The GERD/ hiatal hernia info is intriguing. Also, I have been taking magnesium supplements for about two months now; I heard about this on the Daily Strength atrial fibrillation forum; a good and informative site. So far, so good! but causality is hard to determine...it's sort of a fingers crossed thing for me...

Sir Noddinoff: I did a quick search of your machine and it sounds very intriguing. Were you using a machine that responded to your events with more pressure before?

[Pugsy]

You are correct. The M series machine is not compatible with SleepyHead and I don't have any idea if the M series even gathers the data that I was thinking might help you and if the machine doesn't gather it then even if it was compatible with SH we wouldn't be able to see something that wasn't gathered.

Oh well...it was a sort of a good idea.

BTW my first machine was the M series Auto with CFlex..then I found one with AFlex. I really liked it. I know people said it was noisy but I never found that to be the case and neither did my husband. He's been known to poke me in the ribs to tell me to put my mask on when in fact I had it on and the machine was working just fine. He's now learned that the thing to do is feel for the vented air to make sure I have the machine on. I told him I was getting a bit aggravated with the wake ups from the elbow in the ribs.
Of course being a data hound I yielded to the lure of the extra data that the PR S1 machines gather when compared to the M series.

[midnight_skulker]

My first episode of AF was in November 2011. I was also experiencing pain in my right side. The pain turned out to be a strained muscle. This happened in the middle of the day while I was doing yard work. I thought I might be having a heart attack. My wife took me to the ER and they put me in the hospital and called in a cardiologist. I was in the hospital for four days in continuous AF. The cardiologist tried various meds and performed a cardioversion which stopped the AF and sent me home. At my cardiology clinic a sleep study is part of the standard work up for patients with AF. The sleep study determined that I did have apnea and I started Bipap treatment which I have been doing since then. I've never been aware that I had any problem sleeping. Meanwhile, my AF returned and my cardiologist tried more meds and two more cardioversions which only worked for a couple of days. My cardiologist referred my to an electrophysiologist. When I arrived at my appointment I was in full AF. The doc said that was good because he could easily see the spot in the heart that needed to be burned by a catheter ablation. I was awake during the procedure and could watch on a large TV screen. The AF stopped immediately after the ablation. So far, so good. I had the catheter ablation in April 2012 and I'm not aware of having any additional AF episodes and I'm not taking any blood thinner. One problem is that my pulse is slow now. It's usually in the 40's.

[MRRPM]

I had my first episode of Afib around three years ago, took flecanide & diltizem together to keep it in check, then, the pills started to not work, as I went into Afib again a few times. My doc ordered an RF ablation around 3 mos ago, so far, no Afib, and am off all meds now. He also ordered a sleep study, the study found obstructive, & central apneas. I kinda think apnea was causing, or helping cause my Afib, since mosta the time, I wokeup with the Afib.