I was diagnosed in March with sleep apnea (moderate) with an average AHI of 24. I just got my results with an oral appliance I was prescribed. I got a score of 4. Anything less han 5 is considered not having sleep apnea. One problem solved. I read that 46% of afibbers have sleep apnea. Sounds like the biggest cause of afib for people that have no heart problems or other problems.

That's great Petey. I was told to ask my dentist about it. Who prescribed it for you? Did insurance cover it?
So I guess you had to do another sleep study with the appliance?
I really do not want to do that again. I don't know how I slept at all, It felt very claustraphobic and restrictive with all those wires. Seemed like I was awake most of the night.
The sleep Dr told me that I had mild apnea and wouldn't need c-pap normally. He would just advise weight loss, not to sleep on my back, and possibly the oral appliance. BUT....because of the a fib he was really pushing the c-pap. I'm a very cooperative patient except for this. I'm not ready to go that route. I do want to try the oral appliance though.

I got a CPAP and I have never slept better in my life. Its completely quiet and if you have aFib its so much easier on your heart at night. My insurance pays for it and now I could never sleep without it. We even took it on a cruise with us and it made all the difference in the world. I had severe sleep apnea but I'd get the CPAP no matter what. The apnea just gets worse eventually. My husband loves it because I don't snore anymore.

Insurance paid 100%. I took the "at home" sleep study. My regular Dr prescribed it. It costs about $300. The thing is, many people get "attended" sleep studies at centers. The private ones cost $3000. There are cheaper ones with one year waiting lines. Attended ones are good if they want to do a "split study" (half CPAP on/half CPAP off), do titration (fancy word for adjusting a CPAP), they are checking for REM sleep disturbances, or if they want to make sure you didn't hook the machine up to your dog at home. For afib, the home study measures everything you need (oxygen levels, type and amount of apneas, heart rate, and length of time not breathing). Ultimately, the diagnosis is made soley on AHI (apnea/hypopnea index) and oxygen levels.

I was not going to have the overnight sleep study because I didn't think it was warranted, is too creepy, and I can identify a wasteful procedure when I see it (btw, medicare and insurance companies accept the home study now). For my followup with the oral appliance, I talked them out of an attended study because you can't really titrate an oral appliance. To adjust it, you need a wrench. Anyway, I knew that I was sleeping much better, and whether I got a 3, 4, or 5, I knew it helped the afib.

I picked the oral appliance because I can't use a CPAP (too Michael Jackson-like for me) and for moderate and mild sleep apnea, oral appliances work fine and compliance is close to 100% whereas for CPAP it is barely 40%. Most people don't want to be hooked up to what looks like ER equipment every night. It must be a real "chick magnet" for younger guys too! :-)))

There is a website (google "I hate CPAP) that shows all the different appliances. I have an Oasys (www.oasyssleep.com/). Bottom line is: It works!!!

Thanks Petey,
That's exactly how I feel about cpap.
Yeah, I had the overnight attended study and it was no fun. My mom always told me I was a "princess and the pea" sleeper as a child. So hooking me up to all the wires--it's like your head is covered and wires taped at the back of your neck and under your chin--didn't make for a good night. Interestingly enough though, I did sleep for about the 1st 4 hours. Enough to see that I do have sleep apnea.
I am working on weight loss and do feel that alone is making a difference. I do feel like I am more rested and my husband says I don't snore as much. I think the oral appliance sounds like the way to go at this point.

Next question everyone:
If you have sleep apnea and use either an oral appliance or c-pap...have you noticed any improvement, or less frequent episodes of a fib?

Marikay, My wife uses the dental mouthpiece. The cost was $2k and insurance did not cover it. She ha been wearing it for 3 years and it works for her. You might go on line and possibly locate a more reasonably priced source. Hope this helps.

It's too early to tell, but for me, I am basically asymptomatic and persistent afib, so it is not so simple. I have a portable EKG, that shows my afib (all the time), so that is all I have to tell me I still have it. I do notice that my heart rate is better, I'm not as tired, and although I don't have any P waves no matter what I do, I notice the squiggly lines are less squiggly. Curing apnea is a requirement for most ablation centers now because it increases the odds of long term sinus rhythm.

Whenever I look at the EKG, the QRS wave looks like a cursive F and the T wave looks like a lowercase R, so with all the squiggly lines, it looks like a sloppy, cursive "fibrillate". I know, I think too much. :-)

FibRillate

I guess I'm different, because medicare required a split night study. The room was gorgeous...like a hotel. It was not a hospital setting at all. I had a queen sized bed and flat screen TV. Being hooked up to all the junk isn't fun, but I was happy to find out that sleep apnea was contributing to my fatigue. I honestly don't trust the home studies. I'm on C-Pap and love it. I now can't sleep without it. I guess everyone is different.

BTW, I have Medicare and an AARP medi-gap policy and everything was covered, including a new mask every 3 mo. I love the masks with the nasal prongs.

Q: What is the difference between a Home Sleep Test and an in-lab sleep study?
A: A home sleep test is self-administered and performed by you in your own home versus sleeping overnight in a sleep lab. The HST measures oxygen saturation, heart rate, and air flow. It will also record snoring and sleep positions. OSS uses the highest quality equipment which can now measure brain waves and sleep time.

Q: Which type of study to I need?
A: Most patients will need an HST. There are instances where patients will suffer from multiple ailments and a more sophisticated study will be required to obtain the appropriate amount of information to be able to correctly diagnose a patient.

IDS - HOME SLEEP TESTING CENTRAL
IDS is very excited about the Centers for Medicare & Medicaid Services publishing a National Decision Memo on March 13, 2008 approve unattended home sleep testing using Type II, Type III and Type IV portable testing devices as qualification for CPAP therapy. Other commercial insurers are now starting to follow Medicare lead by introducing similar policies. We feel this will help lower a major barrier in testing and treating many of the millions of undiagnosed Americans who would have refused or otherwise been unable to be tested in a traditional lab setting.

IDS SLEEP - Home Sleep Testing Program
IDS is an Independent Diagnostic Testing Facility will provide a home testing service which utilizes our advanced web based technology infrastructure along with a huge network of DME/HME suppliers, sleep labs, and other providers around the country, so that they may quickly and efficiently courier test equipment to patients in their locale, for whom physicians have ordered our testing service. IDS provides the testing instruction, along with the test equipment (type III or type IV portable device), disposables, 24hr patient phone support, scoring, professional interpretation by accedited physicians, and automated test report distribution to the referring physician.

Our technology infrastructure and unmatched inventory of home sleep testing equipment allows us to provide the most professional, accurate,and effecient service available. Our mail order model allows turnaround in as little as 4-5 days! And soon for patients covered by many commercial insurers, we will introduce our Supplier delivered model, which will allow testing turnaround time in as little 24-48 hours from the physician's order. Compare this turnaround time to weeks and often months with a traditional in-lab model.

Thanks for great info Petey,
I don't see why I needed a bells and whistles sleep study either. It was a very nice "hotel room" feel, except for a green light on the wall that bothered me and I could only turn on one side because of all the wires. It does record brain waves and when you are in REM etc, but why is that necessary when it is most likely an airway/snoring issue? Then after I nixed the c-pap idea he handed me a tennis ball to stick on the back of my PJ's so I don't sleep on my back! This all cost my insurance $$$$. I know I need to take this problem seriously but I just feel I will never be able to use cpap. And during the sleep study they never tried it on me either, because my apnea wasn't bad enough. If I have to do another one I will ask about an in home study.
I think I have sleep apnea because I have gained about 25 lbs since I hit menopause. I was never overweight before. I have lost 15lbs so far and I can tell a difference. Between that and an oral appliance I think I will be good.
However...I really wonder if treating the sleep apnea makes any difference in decreasing the frequency of a fib episodes?

I can only assume that because of the atrial fib Medicare insisted on the study I had. They didn't give me the options of having one at home.

It puts less stress on your heart to treat sleep apnea. That is good and should slow progression and atrial remodeling.

Petey where did you get the portable ekg machine?

The best one is made by OMRON for $300. Just press it to your chest and you get exactly what you need. You can see the P, QRS, and T waves (if present) clearly. I'm sure you know what AFIB looks like anyway. Also gives heart rate and other data. You can download to your computer and show your DR or show the runs from the machine with dates and times. Here is one place to get it:

http://www.amazon.com/Omron-Portable-Handheld-HCG-801-Monitor/dp/B0019WH3EO