ATRIAL FIBRILLATION or A-Fib is the name give to an abnormal heart rythym that is relatively common and affects millions of adults.

Atrial fibrillation can be caused by sleep apnea therefore 100% of patients with SAtrial Fibrillation should be evaluated for sleep apnea. Patients with Atrial Fibrillation should be tested even if they have none of the commonly seen symptoms of apnea such as snoring, excessive tirednedd, weight gain or hypertension.  Many patients have sleep apnea but do not fit picture often associated with apnea.  Unfortunately while the percentage of patients with sleep apnea in cardiology offices may be as high as 70% it is estimated only 10-20% are ever diagnosed. I have recently created a new company Sleep Well Illinois to set up UNIVERSAL SLEEP APNEA SCREENING IN CARDIOLOGY PRACTICES AND INTERNAL MEDICINE OFFICES.

Universal screening for sleep apnea can be done with a simple questionnaire and at risk patients can have a portable sleep test in the comfort of their own home in their own bed.  Most patients have mild to moderate sleep apnea and do not require CPAP. These home sleep studies should always be evaluated by board certified sleep specialists prior to initiating treatment.

Atrial fibrillation most commonly develops atrial in white male adults over 65 years of age. It also affects women and non-white adults an can happen to younger adults as well and may be most dangerous to that group.

Atrial fibrillation can present in Intermittent or as Chronic persistent forms. Intermittent often called paroxysmal comes in seperate episodes of varying lengths and frequencies and will the stop spontaneously. The chronic form or persistent atrial fibrillation usually does not stop spontaneously.

The atria are the upper chambers of the heart which In atrial fibrillation work incorrectly because of abnormal electrical activity. This creates pooling of blood in the chambers that is not effectively pushed out, this static blood allows clots to form.

Older adults are at increasingly high risk of developing A-fib especially if they have other types of chronic heart disease such as heart disease secondary to hypertension, previous myocardial infarctions and valve disease.

Life style causes of A-fib include binge drinking. This will often be transient in nature and is associated with holidays, social events and weekends. Excessive caffeine and medications for lung and asthma problems such as theophyline can increase A-fib risk.

Atrial fibrillation caused by sleep apnea can be treated with CPAP or Oral Appliances which are both considered first line treatments for mild to moderate sleep apnea. Studies have shown that 90% of patients prefer oral appliances to CPAP when offered a choice. Many patients are never given a choice because of ignorance about how effective these appliances are for mild to moderate sleep apnea. CPAP is always the first choice of treatment for Morbidly Obese patients with sleep apnea and for patients with severe sleep apnea and central sleep apnea.

Patients with severe sleep apnea who do not tolerate CPAP should be treated with oral appliance which have been shown to give equal benefit from long term outcome studies of large patient bases.

Sleep apnea is a condition where patients quit breathing completely (Apnea) or partially (Hypopnea) numerous times throughout the night. The AHI or Apnea/Hypopnea Index is used to measure severity. 5-15 episodes per hour is considered mild, 16-29 episodes per hour is moderate and thirty or more is considered severe.

Severity of sleep apnea is also affected by the amount of oxygen saturation. Severe drops in oxygenation are more serious and dangerous .

Oral Appliance therapy can cure Atrial Fibrillation caused by Sleep Apnea.  It is absolutely essential that the patient should be closely followed by his cardiologist and sleep specialist.  While Dental Sleep Medicine provides the preferred choice of treatment for most sleep apnea patients dentists are only a small part of the medical team.  Patients with sever problems should seek out Diplomates of the American Board of Dental Sleep Medicine.