Impact of obstructive sleep apnea treatment in patients with paroxysmal atrial fibrillation.

This is a multi centre prospective randomised controlled trial that aims to evaluate the impact of continuous positive airway pressure (CPAP) for 1 year on atrial fibrillation (AF) burden in patients with obstructive sleep apnea (OSA). Following diagnosis of at least moderate OSA, patients randomised to the treatment arm will commence CPAP therapy while patients in the control arm will not. CPAP therapy comprises a mask that is worn while sleeping that provides positive airway pressure. All patients randomized to CPAP therapy will receive CPAP education, hands-on demonstration, careful mask fitting and acclimatization prior to titration. Pressures are titrated in the range of 4-20cm H2O until obstructive events are eliminated or maximum CPAP is reach, based on present guidelines for OSA management. The number of visits required for pressure titration will be based on physician clinical judgement. Patients will be followed at 3, 6, 9 and 12 months after enrolment into the study, to assess compliance, efficacy and symptoms. Patients in the control arm will also be followed at these time points for ongoing review. CPAP adherence will be monitored by clinical evaluation and by utilising the remote monitoring function on CPAP machines.