Skip to main content

Main menu

  • About Us
    • Leadership
    • Our Team
    • Vision, Mission and Values
    • Health and Economic Impact
  • Our Research
    • Research Focus
      • Brain Health
      • Cancer
      • Cardiovascular Conditions and Diseases
      • Digital Health
      • Health Policy
      • Immunity and Infectious Diseases
      • Joint Health and Mobility
      • Respiratory and Lung Health
      • Spinal Cord Injury and Rehabilitation
    • Research Centres and Programs
      • BC Centre on Substance Use
      • Centre for Cardiovascular Innovation
      • Centre for Clinical Epidemiology and Evaluation
      • Centre for Hip Health and Mobility
      • Centre for Lung Health
      • Djavad Mowafaghian Centre for Brain Health
      • Immunity and Infection Research Centre
      • International Collaboration On Repair Discoveries
      • Ovarian Cancer Research Centre
      • Vancouver Prostate Centre
      • Community Research Program
      • Emergency Medicine Research Program
      • Hematology Research Program
      • Rehabilitation Research Program
      • Skin Research Program
      • Other Research Focus Areas
    • News and Stories
    • Researcher Directory
    • Events and Workshops
  • Research Services
    • New to VCHRI
      • Working at VCHRI
      • Regulations and Training
      • Membership with VCHRI
    • Starting Your Project
      • Research Facilitation
      • Awards and Funding
      • Grant Management
      • Operational Approval
    • Developing Your Project
      • Clinical Trials Administration
      • Clinical Research Unit
      • Research Privacy
      • Financial Policies and Procedures
    • Additional Support
      • Education and Training
      • Communications and Branding
      • Media Relations
      • Study Recruitment Support
      • Innovation and Industry Partnership
    • Internal Awards
    • Clinical Research
    • Innovation and Partnership
  • Participate in Research
    • Reasons to Participate
    • Participant Stories
    • Find a Study
    • Recruitment Support

User menu

  • Log in

Breadcrumb

  1. Home
  2. Our Research
  3. News and Stories
  4. A dangerous combination, sleep apnea and irregular heart rhythm prove difficult to diagnose in tandem

A dangerous combination, sleep apnea and irregular heart rhythm prove difficult to diagnose in tandem

Stories Aug 17, 2021 4 minutes

Researchers find obstructive sleep apnea is underdiagnosed among patients with non-valvular atrial fibrillation, highlighting the need for increased screening.

While the noise of someone snoring loudly is hard to ignore if you’re sleeping next to it every night, the stress that it puts on the heart can be easy to miss. Chronic snoring is often associated with a sleep disorder called obstructive sleep apnea (OSA), which occurs when the muscles of the throat relax during sleep and close off the airway. This cuts off the air supply to the lungs and can trigger highly disruptive gasps for air and low oxygen levels. OSA can cause a myriad of health problems and recent research suggests it could be a possible cause of non-valvular atrial fibrillation (AF), a common heart condition that is displayed as an irregular heart rhythm. Because of this, notes Vancouver Coastal Health Research Institute scientist Dr. Iqbal Ahmed, accurate screening for OSA among AF patients is critical.

“On their own, OSA and AF can cause serious health complications and increase the risk of mortality,” says Ahmed, a respirologist with Vancouver Coastal Health and head of the Department of Medicine at Richmond Hospital. “However, the condition of OSA among AF patients does occur and some research has shown its prevalence as high as 85 per cent. And yet, there exists a gap in official OSA diagnoses among this population.”

Dr. Iqbal Ahmed is a clinical associate professor in the Department of Medicine at the University of British Columbia.

While AF can exist without any symptoms, people with the condition may experience discomfort or fluttering in their chest, heart palpitations, unexplained fatigue, light-headedness or shortness of breath. Medication is most often used to help manage AF. In more serious cases, cardioversion, in which an electric current is sent to the heart, is necessary to restore the heart’s normal rhythm.

“Treating moderate or severe OSA can improve health outcomes and quality of life for AF patients. However, this first requires accurate screening and diagnosis of OSA among this specific population, keeping in mind that they may not experience classic sleep apnea symptoms of tiredness, obesity or loud snoring.” 

“Unfortunately, you can’t send every patient for an overnight sleep study in a lab, which is the most accurate way to diagnose OSA,” adds Ahmed. “It would be phenomenal to have a user-friendly way of picking up sleep apnea in an AF clinic, or to at least identify those who do not have OSA.”

Improving screening for OSA requires more effective assessments and greater collaboration

In a study recently published in CJC Open, Ahmed and his colleagues looked at whether standard OSA screening tests that do not require an overnight sleep lab stay can effectively detect the condition among AF patients. The researchers employed acoustic pharyngometry (AP), which measures the narrowness of the throat, the NoSAS (Neck, Obesity, Snoring, Age, Sex) questionnaire, and the STOP-BANG (Snoring, Tiredness, Observed apnea, blood Pressure, Body mass index, Age, Neck circumference and Gender) questionnaire, to identify moderate to severe OSA sufferers among an AF population. They also administered the Home Sleep Apnea Test (HSAT), which is an OSA diagnostic test reasonably comparable to in-lab testing, to the same population and compared results across assessments. 

The researchers’ findings determined that although AP, NoSAS, and STOP-BANG are user-friendly OSA assessments, they were not as effective at detecting OSA among AF patients as the HSAT.  

“The lack of efficacy of some of those tests could be due to them being weighted toward tiredness and loud snoring, which AF patients may not be experiencing,” explains Ahmed.

The researchers found that OSA was markedly underdiagnosed among the population, which was consistent with other studies. 49 per cent of the study population had moderate or severe OSA.

“We concluded that until we find a better way of picking up high risk OSA patients in AF clinics, they should all be considered for HSAT testing,” explains Ahmed. 

For patients who have been diagnosed with both OSA and AF, studies have shown that treating OSA—through use of a continuous positive airway pressure machine—can help to reduce AF symptoms and progression. “This tells us that dedicated OSA screening is of value.” 

“Ideally, there would be closer collaboration between sleep doctors and cardiologists so that as patients are seen for follow-up, they can then also be seen for OSA management,” says Ahmed. “With cardiology increasingly looking to lifestyle measures for improving heart conditions, I anticipate that proper management of sleep apnea will be used more often in the future to help treat AF.” 

Researchers

Iqbal Ahmed

Related Articles

The future of patient-tailored sleep apnea care

Keeping a finger on the pulse of a good night’s rest with a device for sleep apnea

When snoring goes from personal quirk to public health concern

Share:

  • Facebook
  • Linkedin
  • Twitter
  • Email

Related Research Centres/Programs

Centre for Lung Health

Get the latest research headlines in your inbox

Subscribe

Recent News and Stories

Type
Announcement

Top Graduating Doctoral Student Award and Rising Star Award 2022 Recipients

Jun 28, 2022 award, trainee
Type
Stories

Cannabis legalization may have upped the number of older adults driving high

Jun 23, 2022 marijuana, senior, driving, men
Type
Stories

Heath care priority management post-COVID-19

Jun 17, 2022 COVID, patient engagement, health burden
See more news

Get updates!

Join our newsletter mailing list to stay up to date on features and releases.

Subscribe

Quick Links

  • News and Stories
  • Careers
  • Events
  • Media Enquiries

Follow Us

  • Twitter
  • LinkedIn

© 2022 VCHRI. All rights reserved.

  • Contact
  • Privacy Policy