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Does Sleep apnea cause afib?
What is sleep apnea?
Sleep apnea also known as obstructive sleep apnea is a sleep disorder where one’s breathing is repeatedly interrupted while they are asleep.  The condition afflicts more than 18 million Americans and is believed to be a risk factor for many other conditions including atrial fibrillation.  Its prevalence among children is estimated at between 2-3%. It affects both males and females and can afflict persons of any age group.
The apnea refers to the obstruction of the airways, which can last for as long as 10 seconds at a time. It occurs when the airway muscles in the back of the throat are not strong enough to keep the throat open, thus interrupting the efforts to breathe. Sleep apnea could also be caused by the brain failing to properly control breathing while one is asleep, resulting in irregular breathing (this is referred to as central sleep apnea).
Sleep apnea has been known to cause low blood oxygen and fragmented sleep. This can result in a host of other problems that include memory, mood, heart disease, and hypertension due to oxygen starvation and disturbed sleep. 
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What Is Atrial Fibrillation?
Atrial Fibrillation in some instances referred to as “Afib” is the rapid and irregular and often abnormal heart rhythms. The condition afflicts up to 2.5 million Americans. It results from chaotic and disorganized electrical signals in the upper chamber of the heart that results in improper contraction of the chamber. The chamber usually quivers instead of contracting this affecting blood flow to the body and to the heart muscle. The improper flow of blood could result in blood clots that could lead to a stroke.
What Happens During Afib?
Atrial fibrillation usually results in the atria of the heart losing their organized normal electrical activity. They start beating in an unorganized and chaotic rhythm, which in turn makes the ventricles develop an irregular beat.
During atrial fibrillation, the heart becomes less efficient and one may feel palpitations (fluttering sensation in the chest as the heart beats erratically. You may feel a shortness of breath, dizziness, fatigue, and weakness. However, some patients never have any of these symptoms and you may never know you have atrial fibrillation at all unless you go to a doctor. 
Symptoms of Atrial Fibrillation
1. Gasping episodes and pauses in breathing during sleep
2. Headaches when you wake up in the morning
3. Persistent loud snoring that wakes up your partner
4. Waking up just as tired as when you went to sleep
Relationship between AFib and Sleep Apnea
We do not have a very good understanding of how sleep apnea affects Afib but our knowledge is growing. According to estimates, almost half of the patients with atrial fibrillation also have sleep apnea. It is also estimated that persons with sleep apnea are up to four times more likely to develop Afib. If a person has untreated sleep apnea it can result in the development of other risk factors such as diabetes and hypertension, which increase the risk of developing atrial fibrillation.
Research has shown that sleep apnea is a direct trigger for arrhythmias during sleep. The heart has to deal with chemical changes and mechanical stresses every time one is startled by a lack of oxygen. Over time this may contribute to the development of atrial fibrillation. The physiological and chemical changes can result in thickening of the heart walls, stiffening of the heart, and chronic high blood pressure. All the changes predispose one to the risk of arrhythmias and reduce the efficiency of the heart over time. 
Sleep Apnea and Afib Treatment
Studies have shown that persons who have had untreated sleep apnea for a long time may have an impaired ability to respond to Afib treatments. For instance, persons with both sleep apnea and Afib may not respond as expected as compared to Afib patients that do not have sleep apnea. Patients with sleep apnea are also more prone to recurring episodes of Afib after catheter ablations or cardioversion as compared to Afib patients on the same medication but without sleep apnea. As such, you can make Afib treatments more effective by treating both conditions simultaneously. 
The Close Association Between Afib, Sleep Apnea, and Cardiovascular Disease
Sleep apnea and Afib have a lot of common risk factors and hence developing one significantly increases the risk of developing the other. The current increase in the prevalence of atrial fibrillation and sleep apnea is likely as a result of increasing rates of obesity and cardiovascular disease. The close association between obstructive sleep apnea and cardiovascular disease and cardiovascular disease and atrial fibrillation may obscure the direct causal correlation between Afib and sleep apnea. The two chronic diseases are however closely associated though the interconnection of the pathophysiology is complex and could even be bidirectional. Research has shown that Afib contributes to sleep apnea even as sleep apnea may promote Afib. 
What are the Treatments?
According to studies, treating sleep apnea and Afib simultaneously has been shown to be very effective at managing Afib. One of the most effective ways of treating sleep apnea is through a CPAP oxygen mask. This significantly improves a patient's breathing and in doing so reduces the symptoms of atrial fibrillation. Moreover, treating atrial fibrillation with CPAP often makes Afib procedures such as ablations and cardioversions more successful.
Apart from using CPAP, ablations are also very effective procedures for people with atrial fibrillation. Ablations come in two types:
1. Catheter Ablation – A cardiac electrophysiology procedure in which a thin tube is inserted into a blood vessel in the neck or leg and is then guided to the neck. The electrophysiologist will then use heat, cold or radio energy to scar heart tissue from where the irregular heartbeats are being generated.
2. Surgical Ablation – The physician will insert either a tiny robot or video camera into the chest cavity and then guide the ablation to create scar tissue on the part of the heart that is producing the irregular heartbeat.
Other treatment options include:
1) Drug therapy
2) Implantable cardiac defibrillator
3) Pacemaker
Conclusion
The common mechanisms linking atrial fibrillation and sleep apnea are complex and influenced by many mechanisms. Studies have shown that sleep apnea may cause electrical and mechanical changes in the heart that may result in arrhythmia such as Afib. Treating both sleep apnea and Afib through using CPAP, ablation, and medication will significantly reduce the reoccurrence of Afib. For patients suffering from both conditions therapy in conjunction with lifestyle modifications will go a long way towards reducing the impact of Afib and sleep apnea.
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