The SNORE-AF Trial: Does treating obstructive sleep apnoea improve atrial fibrillation?

Dr Danlu Liang, Melbourne Health

Postgraduate Scholarship

Years funded: 2025 - 2027

Investigating the link between obstructive sleep apnoea and atrial fibrillation

Atrial fibrillation (AF) is an irregular heart rhythm that is becoming increasingly widespread and can lead to other serious conditions such as stroke and heart failure. AF can be difficult to treat even with medications and cardiac ablation, a procedure where thermal energy is delivered to cardiac tissue to disrupt abnormal electrical circuits. However, success of this procedure also depends on treating AF risk factors and associated conditions including obstructive sleep apnoea (OSA). This is a common disorder affecting 20% of the population where people intermittently stop breathing whilst asleep and is treated with a breathing machine known as continuous positive airway pressure (CPAP). Both AF and OSA are associated with other significant diseases which carry high risk of complications, death and frequent hospital presentations, placing significant burden on the healthcare system. Due to shared risk factors and patient groups, a link has been described between AF and OSA. However it is unknown if OSA causes AF and if treating OSA may treat AF. Existing research in this area has shown conflicting results with studies being small or of poor quality.

The SNORE-AF study: examining the effect of CPAP on AF patients

The SNORE-AF study aims to definitively answer this question by examining the effect of CPAP treatment for OSA in AF patients undergoing ablation This study is a randomised control trial which is the gold standard for evaluating the effectiveness of a treatment in research, where half the participants will undergo treatment with CPAP and the other half will not have CPAP treatment but will be observed. We predict participants who have their OSA treated with CPAP will have less AF, increasing the success rates of their procedure, and also have improved symptoms as well as better quality of life. If successful, the results will enhance understanding of the relationship between OSA and AF, result in a new treatment option for AF and have wide-reaching implications given how common both conditions are and its significant adverse health effects. It is likely to change current practices of how clinicians treat AF and result in new international AF management guidelines with regards to OSA screening and treatment.