Sleep apnea and PM.

Hello all,

Received my PM 1/19/2021

I just had a sleep apnea test . (two day home test)  I requested it due to my diagnosis of SSS.  I heard sleep apnea can cause isssues with your electrical system.

Sure enough it came back that I have severe sleep apnea.(AHI 52.9)  Now I wonder if this was the issue all along.  Any one have a pm implant due to sleep apnea? 

On the test result it stated that my HR lowest reading was 38.  My pm is set to kick in at 60. I called my PM nurse and she stated that the peripheral pulse is different than the actual hr and the report was probably wrong . That doesnt sound right to me. A hr is a hr correct? I was hooked up to pulse /o2 sensor two nights.  

I had the nurse run an evaluation on my pm to make sure its working.  I am waiting for her to call back,but I assume it is working or she would have called back sooner than later.

Thoughts on the HR or sleep apnea and PMs?

Thanks all! 





Sleep apnea and SSS

by Gemita - 2021-04-22 14:56:02


Your minimum pacemaker setting of 60 bpm is no doubt correct and your heart rate will not be allowed to go much below this rate.  It could drop a few points below this but not to 38 bpm unless the pacemaker is malfunctioning.   

Some external monitors will not be able to cope or effectively record irregular heart beats like ectopics and some other arrhythmias which you may have got during the two night home study.  Beats like ectopics are inefficient beats and may not always be detected by a home monitoring device, whereas the pacemaker will clearly be able to detect a slow, pausing, skipping, inefficient beat like an ectopic beat.  I asked my EP the same question and he replied "your heart rate cannot fall below the set minimum of 70 bpm.  Your home monitor recording a 43 bpm heart rate was clearly wrong and caused by irregular heart beats which were missed by the home monitor but detected and recorded accurately by your pacemaker". 

Now that you have had a home sleep study and it found an AHI of 52.9, I would recommend that you get a full in hospital sleep study carried out to confirm all aspects of your sleep apnea, whether it is obstructive or central sleep apnea, whether you have any other sleep disorders?  I wouldn’t just settle for a home study, as useful as they are.  Yes sleep apnea can cause many serious health conditions, including electrical disturbances of the heart.  To determine the actual cause of SSS may be difficult since there might have been many factors involved in triggering electrical disturbances, not just sleep apnea, including ageing itself, thyroid disease, heart disease, scarring of the heart’s electrical system, certain medications, inflammatory disease and so the list goes on.  Whatever the cause Loretta, you have a pacemaker now and a fix for your SSS.  Once it starts it usually progresses, so sooner or later we would be looking for pacemaker support.

Good luck with your sleep apnea.  My AHI index was 35 during a full in hospital sleep study.  I also have SSS (tachy/brady syndrome), lots of horrible arrhythmias and had pausing and syncope prior to my pacemaker.  My improvement with my pacemaker has been incredible.  Very pleased in all respects.  Good luck

heart problems and sleep apnea

by Tracey_E - 2021-04-22 15:08:08

Pacers can confuse monitors, and things like pvc's can throw off the count. It's much more likely that the report is off than the pacer isn't pacing properly.

There is a high incident of sleep apnea among cardiac patients but no clear connection why. They often go hand in hand, but I don't believe one causes the other. 

Which came first

by TLee - 2021-04-22 16:09:05

I think this is kind of a chicken-or-the-egg situation. I also have sleep apnea, and I believe that I've had it for most of my life. My father had it & could snore the house down! I have had instances of startling awake for as long as I can remember. When we were first married, my husband used to reach over & give me a shake when he thought I'd stopped breathing. I also did in-home study & (surprize, surprize) I have moderate-to-severe apnea. Did this take a toll on my heart & eventually cause my current problems? Was it because I smoked through my late teens & early twenties? Was it my COPD/asthma that went untreated for years--or the over-the-counter meds that I used to self-treatt? Maybe the asthma attack that finally almost killed me did some lasting damage.One doctor told me that I MUST have had a heart attack at some point, but search me. In other words, I don't know what caused my heart to go wonky. 

I had a fingertip O2/heart rate monitor that would go absolutey crazy when I was experiencing a-fib. It would show 40 bpm, then jump to 80, then 120, then down again to 50. Told my cardiologist, & he said that they are not set up to deal with arrhythmias, only to chart several regular beats & arrive at an average bpm. Maybe that was an issue during your study?

I understand that we all wish we knew more of the why, when, how, concerning our health. Sometimes it's enough to say, I'm here now, how can I make the best of it? Take care!

Sleep apnea and PM.

by Loretta - 2021-04-23 21:42:18

 Thank you all for the input. I didnt know pvc's can effect tests like that.  I have 3-4 an hour so it all makes sense.

My nurse called back and said my pacer was working well ,no drops in hr ,some svt and not to worry. I guess my monitor sends a report every five days,so no news is good news from cardio.

Being new to this I still tend to worry when someone states my hr is 38 when I know it shouldnt be. 

Now to fix my apnea ......


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