Your heart depends on a regular rhythm to work most effectively, like a drumbeat. A number of health concerns can occur when your heart beats out of rhythm.

While you may notice when your heart skips a beat, you may not notice it while you sleep.

There are a number of heart rhythm disorders and sleep breathing disorders.

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder where your usual breathing is disrupted. While the interruption may be relatively brief, the pause (and the other frequent pauses that tend to occur with it) can have effects on your heart.

An estimated 25% of people who use a pacemaker to maintain a regular heart rhythm also have sleep apnea. This suggests there may be a close relationship between sleep apnea and arrhythmias.

“Sleep apnea is a likely cause of arrhythmia in some people, so it’s important to treat it.”

People with heart disease also experience sleep apnea in greater proportions. This means it’s likely that some people with sleep apnea may have already had some heart problems. Sleep apnea can worsen this damage which can further increase someone’s risk of abnormal heart rhythms.

What’s the most common heart arrhythmia during sleep apnea?

Slow heart rhythms — or bradyarrhythmias — are the most common for people with sleep apnea. The more severe your sleep apnea, the more likely you may have bradyarrhythmia.

But other arrhythmias can occur. For example, the risk of atrial fibrillation is 2 times as high for people with sleep apnea.

There are several possible causes of sleep arrhythmia, which can be caused by sleep arrhythmia.

Creating intrathoracic pressure changes

It is like trying to drink from a straw when you stop breathing during sleep apnea episodes. The drink still goes nowhere when you try harder to drink from the straw.

This effect is similar to what happens when you try to breathe.

The pressure in your lungs and heart changes from one norm to another. Changes to the way blood flows back to the heart can be a result of these changes. An arrhythmia may occur if these changes are made.

Triggering sympathetic and parasympathetic systems

When you stop breathing, your body can use your backup systems to breathe again. The parasympathetic system slows heart rate, or the sympathetic system speeds the heart up.

Causing myocardial ischemia

Oxygen can drop when you stop breathing during sleep apnea episodes. Hypoxic is when there is a lack of oxygen to your tissues.

“Hypoxia is a concern. There isn’t enough oxygen for the heart to use. Arrhythmia can be caused by a condition known as myocardial ischemia, which is when the heart does not have enough oxygen.”

Episodes of sleep apnea can affect your heart’s ability to receive oxygen. At first, your body tries to compensate in a number of ways.

It may try to make the heart beat faster or stronger to get more oxygenated blood. This can cause the heart muscles to become larger or worn out, affecting overall heart function.

“A lack of oxygen can damage your heart cells. This can lead to scarred and thicker areas that don’t move electrical activity through.”

Some researchers consider the relationship between sleep apnea and heart failure “bi-directional.” This means sleep apnea and heart failure can worsen each other.

Sleep apnea can cause chronic changes to your heart like scarring and lack of oxygen, if it is not treated.

“The electrical signals from the heart can’t move through the tissue as effectively as they could. Cardiac arrhythmias can occur more frequently.”

Ideally, your doctor would test you for sleep apnea before you experience significant changes to your heart. Some risk factors for developing sleep apnea include:

  • Older age.
  • A history of waking up feeling tired or sleepy.
  • The male gender is not the same as the female gender.
  • “It’s obese.”
  • The neck is wider.

If a partner reports that you snore or stop breathing, this may be a sign of sleep apnea. If you are concerned about sleep apnea, you should seek the advice of a doctor.

Screening for sleep apnea risk factors may allow a doctor to recommend treatments earlier in the process.

But it’s possible your doctor may detect an arrhythmia before diagnosing sleep apnea.

You may have symptoms of arrhythmias such as feeling as if your heart is skipping a beat or feeling faint. These symptoms may suggest your heart isn’t beating in an expected rhythm.

If a heart arrhythmia is related to sleep apnea, it is important to treat both conditions.

Untreated sleep apnea can actually make anti-arrhythmic medications less effective. And if you’re doing certain treatments — such as ablation for atrial fibrillation — not treating your sleep apnea can increase your chances of the atrial fibrillation coming back.

The ability to reverse heart damage from sleep apnea depends on how severe the damage is.

Treating sleep apnea with a continuous positive airway pressure (CPAP) machine may help reduce arrhythmias by improving your oxygen supply while you sleep. This device helps keep your airways from collapsing to improve oxygen levels.

If the changes to your heart are not severe, some research suggests sleep apnea-related heart changes may be reversible by using a CPAP machine. In some cases, treatment with a CPAP can improve the left ventricle function of the heart.

But research in 2021 suggests people with moderate to severe sleep apnea didn’t find that using a CPAP reduced the incidence of atrial fibrillation.

While CPAP machines are the gold standard for sleep apnea treatment, other treatments exist. They include upper airway surgery or wearing oral appliances to help properly position the tongue while sleeping.

It is not known if these interventions are effective at reversing sleep apnea-related damage. It is important to continue with sleep apnea treatments to prevent other life threatening symptoms, even though they may not be able to reverse damage to the heart.

Sleep apnea can cause more than a sleep problem. There is research that suggests a link between sleep apnea and abnormal heart rhythms.

Treatment of abnormal heart rhythms and sleep apnea can help keep your heart healthy.

If you have sleep apnea, talk to a doctor about the best ways to treat it.