Afraid to sleep. Most episodes happen at night. What can I do?

I, too, was diagnosed with severe OSA and have used a PAP machine ever since. Just a correction: CPAP won't help with atrial fibrillation if it was the original cause. Once your heart is disordered electrically, that's it...for life. What CPAP can do is to reduce the nocturnal strain on your heart that caused the AF in the first place. By keeping your airway splinted, you keep your optimal range of O2 saturation. The constant severe reductions in O2 in your blood during sleep apnea, with its constant threat of 'dying' , is what makes your heart disordered.....it can't get any rest at night. The CPAP keeps your blood oxygen levels up, and your heart can beat calmly, even down at the low rate of 34 BPM if that's what your O2 demand is and your heart is fit and strong.
So, your cardiologist is partly correct. CPAP won't make AF go away. AF is a progressive disorder (all the modern research makes this quite clear), and left unmanaged it can get worse progressively. The CPAP machine, apart from improving your quality of sleep by allowing you to STAY ASLEEP....not waking up gasping for air sixteen times each night... and therefore going through each successive stage of sleep properly..., will reduce the constant strain on your heart and possibly decelerate the progression you don't want. You have the disorder and it is permanent. It can be reduced in severity with CPAP, but also it needs strict management via drugs, lifestyle changes, catheter ablation (The Gold Standard of care for AF for most patients, especially early), or a pacemaker.
I said your cardiologist is partly correct. He's right on the face of it, as stated. But CPAP is necessary for longevity if you have moderate or severe sleep apnea. Not only will OSA cause sleep disruption, which is very unhealthy (weight gain, metabolic syndrome, kidney and lung problems, dementia, etc), but it causes your heart to continue, even more quickly, to deteriorate. CPAP is essential if you want to live longer, with or without atrial fibrillation.

Hello- I understand your fear. You are not alone!
Are you taking Flecainide on a regular basis? I think you need your be taking some antiarrhythmic regularly but not just with an episode. Other option is to discuss with your dr ablation.
Arrhythmias are scary but since you are on meds dont be afraid to sleep. I put music on or a fan so there is a background noise before bed and I find it helps me!

Thanks for your insight on sleep apnea and CPAP machine. I definitely agree with you and will look into purchasing one. Do you know if Medicare covers these machines?

Either way, I will get one and start using it asap. That way, it will not only help my heart somewhat, but it will also prevent my wife from having to worry about me whether I am breathing or not during the night.

Thanks again.

Wow! I think I can relate to your fear and anxiety. I developed vtach (mostly nonsustained)
from scar tissue following valve surgery in 2017. I also had assorted PVCs, pacs, svt, bigemi ny, etc. I lived in fear and my life was devastated while they sorted it all out. I thought life as I knew it (I’m active and enjoy backpacking. etc.)was over. They got me onto medication that worked(flecainide), did two ablations that were partially successful, and I was able to continue with life as I knew it, thank God. However, I still had some arrhythmias and continued to be afraid and anxious. Sleep was also a problem.
Right now, it sounds like sleep deprivation and fear are the primary issues. Can you go back to the dr who prescribed the Xanax and see if they will increase the dosage or recommend something else? I am also on Xanax for anxiety 2mg per day as needed and can honestly say it has made it possible to live a normal life. I also note, that it seems to decrease the PVCs, etc.
Have they told you about valsalva maneuvers like coughing? I have frequently broken or headed off a run that way. I don’t seem to have AFIB, but it still might be useful.
Are your drs at all understanding or comforting? My experience has been that some are while others just don’t get it. Maybe get a counselor or someone you can talk to when you are afraid. Most cities have a referral system or crisis line you can call.
Please don’t wait; it sounds like the mental and physical are feeding off each other.
You’ve come to the right place here; welcome. I’ve always found caring and responsive people.
Please let us know how you’re doing.

First and foremost, you need to check with your doctor and see what he tells you. I am no doctor so I really cannot tell you what you can do.

I myself have AFIB and a heart rate of 40+ which is very low. It probably goes down to less than 40 when I am sleeping but I need my 8 hours of sleep. I also have congestive heart failure, pulmonary hypertension, pooling of blood in veins due to 2 upper chamber valves leaking blood into my veins.

I have had 3 cathertizations to determine any blockage in veins or arteries, 2 cardioversions to get my heart rate back in normal rhythm, 2 Ablations on my upper and lower chambers to control my heart rate. I was doing fine with my heart rate back to normal rhythm; however, on 8/2/2025, my AFIB returned so I am back to square one.

My Cardiologist wanted to do another Ablation, but I told him thanks but no thanks. I am 80 years old, and I started having all above-mentioned procedures since 2017. I am tired and too old to go through anymore procedures so I will just continue to take my Eliquis for the rest of my life. My Cardiologist said I could go that route if I wanted to.

I am not worried too much about going to sleep at night even though my heart rate is below 40 but if I was going to worry about it and not sleep, then it would just make matters worse for me. If God wants me to wake up in the morning, great, if not, then I will wind up in Heaven with God's help.

You take care and God bless you.

Have you been tested for sleep apnea. My heart was beating so fast at night that it woke me. I am now on a CPAP machine and my heart is not having to react to apnea episodes.