• Younghoon Kwon, Ryan J Koene, Alan R Johnson, Gen-Min Lin, and John D Ferguson.
• Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep Medicine, University of Virginia, Charlottesville, VA, USA. Electronic address: yk2j@hscmail.mcc.virginia.edu.
• Sleep Med Rev. 2018 Jun 1; 39: 134-142.

AbstractSleep apnea (SA) is a common sleep disorder increasingly recognized as a risk for cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. An increasing number of investigations in recent years have linked SA to AF. In this review, we aim to provide a critical overview of the existing evidence in a question and answer format by addressing the following: What is the prevalent association between the two conditions (separating nocturnally detected AF episodes from AF as a prevalent condition)? Is SA a risk factor for incident AF? Is SA a risk factor for recurrence of AF following cardioversion/catheter-based ablation? What is the association between SA and AF in patients with heart failure? Are there signature electrocardiographic markers of AF found in patients with SA? Are there electrophysiology-based studies supporting the link between SA and AF? What other sleep characteristics (beyond SA) are found in patients with AF? What is the impact of SA treatment on AF? What is the effect of AF treatment on sleep? Finally, we address unsolved questions and suggest future directions to enhance our understanding of the AF-SA relationship.Copyright © 2017 Elsevier Ltd. All rights reserved.

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