Syndrome d'apnée obstructive du sommeil et fibrillation atriale - mécanismes, diagnostic et traitement

Obstructive sleep apnea syndrome is characterized by repeated airway obstructions leading to intermittent hypoxia and sleep fragmentation. It is a major independent risk factor for atrial fibrillation, with a high prevalence of obstructive sleep apnea among patients with atrial fibrillation. The pathophysiological mechanisms include intermittent hypoxia causing sympathetic activation and atrial remodeling, as well as negative intrathoracic pressure fluctuations that promote arrhythmia. Diagnosis relies on polysomnography and standardized tools such as the SCOPER system. Continuous positive airway pressure is the standard treatment and has shown beneficial effects on atrial fibrillation progression and recurrence, although study results vary. Integrated management of obstructive sleep apnea and atrial fibrillation, including weight control, is essential to optimize clinical outcomes. Further research is needed to better identify patient subgroups and evaluate different therapeutic options.