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Question 5 - Arrhythmias and OSA

From: Robert O..

1. I have had sleep apnea since removal of my braces in 2000, but not identified until 2006. I have had SVT and atrial fibrilIation (lone), with the SVT episodes 9/8/01, 2/23/06, 5/8/07, and 6/13/07 and went to the ER each time. My heart doctor said it was from the sleep apnea. I am going to an EP specialist at the end of this month.

Because of the arrythmias, I had somnoplasty base of tongue 6/4/07. The last episode was on 6/13/07 and it takes six weeks for the somnoplasty to see results. I am on my 4th week and am now seeing results (tongue size smaller, can see the back of my throat, stopped using CPAP at night).

My question is if the arrythmias are from the sleep apnea, and the last one was 9 days after the somnoplasty which was still too early, do you think the arrythmias will subside as my sleep improves? I am currently on atenolol (beta blocker).

My diagnoses for the sleep apnea is uars/mild sleep apnea

Arousal Index: 43.1/hr
RDI: 13.8/hr
AHI: 5.6 hr
Apneas 3
Hypopneas 18
UARS events 31
Sp02 saturation 94%
Stage 1 sleep 23.1%
Stage 2 sleep 54.8%
Stages 3 & 4 sleep 10.6%
REM 11.5 %

Answer Provided by Dr. Kasey Li
July 5, 2007

There is a close link between cardiovascular disease and sleep apnea. Clearly, it is possible that your arrhythmia is related to OSA, but I don’t expect that it is solely responsible. It is very logical to improve your sleep apnea as part of the treatment for the arrhythmia. However, I would be a little surprised if somnoplasty alone eliminated the arrhythmia when your get off the Atenolol. It seems that your symptoms of OSA have improved after tongue base somnoplasty, but only time will tell. Generally, tongue base somnoplasty can achieve improvement of OSA, but it is uncommon to have a dramatic reduction. Additionally, the results of somnoplasty can reduce with time.

By the way, although your sleep apnea diagnosis is “mild” or UARS, I suspect that it is worse than that since your RDI is 14 and a high arousal index of 43 (if these arousals are related to breathing issues).

Good luck.

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