The Husband That Fell Asleep In The Exam Room

Older Man with Atrial Fibrillation (AFib) and Sleep ApneaDuring a recent office-based sinus surgery, the husband of my patient fell asleep in the exam room. She told me that he often falls asleep when he sits down. He was a bit embarrassed when we woke him but we assured him that he need not worry. I asked him if he is frequently tired during the day, to which he responded “Doc, I’m 70 years old. Of course I get tired!” His wife interrupted to add that they haven’t slept in the same bed for years due to his snoring. The interesting thing is that he is a hearing loss patient of BergerHenry ENT but never mentioned his daytime fatigue or snoring. We discussed a sleep study but he decided against it.

Eight weeks later, his wife returned for a post-operative visit. She told me that she came alone this time because her husband had recently been hospitalized for atrial fibrillation. Atrial fibrillation (AFib) is an abnormal heart rhythm that makes the upper chambers of the heart (the atria) quiver instead of contracting properly. AFib can cause a clot to form and if it ever breaks free, it can enter the bloodstream and cause a stroke. It is estimated that half of all patients with AFib also have sleep apnea and that patients with sleep apnea have 4x the risk of developing AFib. In addition, studies suggest that untreated sleep apnea impairs the ability to control AFib because it reduces the effectiveness of certain AFib treatments. Fortunately, people with both AFib and sleep apnea are less likely to have a recurrence of the heart rhythm disorder if they use continuous positive airway pressure (CPAP) therapy.

Her husband was eventually stabilized and discharged home. At his wife’s request, this time he agreed to participate in a sleep study. The test diagnosed a moderate degree of sleep apnea and he consequently started CPAP therapy. As of this writing (several months later), he has remained free of any complications related to AFib. Equally as important, he is sleeping in the same bed as his wife for the first time in years and is no longer snoring.

This case really underlines issues with aging and fatigue. As we age, our sleep requirements and energy levels change. However, it is not normal to fall asleep whenever you are at rest. Just because you are aging, it doesn’t mean that your quality of life should suffer. Also, as we age the risk of heart disease increases. In many instances, sleep apnea may be linked to heart disease.

If you or your partner suffers from heart disease, snoring, or fatigue, consider seeking treatment. Improving your sleep may improve your life.

Learn more about Sleep Apnea and Snoring.


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