Atrial fibrillation and sleep apnoea: guilt by association?

Atrial fibrillation (AF) and obstructive sleep apnoea (OSA) are both common, often underdiagnosed conditions with serious sequelae. An association between these two conditions has been recognised but the nature of this relationship remains a topic of active debate. Despite that lack of strong, randomised controlled trials, there is a considerable body of data indicating that not only does untreated OSA provide the substrates and triggers for AF but that OSA, itself, is also a therapeutic target for the management of cardiovascular disease in general and of AF in particular.