Many people have experienced sleepiness the day after a poor night’s rest. You might blame your tiredness on a late bedtime or too much caffeine the night before. But having a heart condition such as atrial fibrillation (AFib) can also influence how sleepy you feel during the day.

AFib is a type of arrhythmia (irregular heartbeat). When your heart beats in this rhythm, it may feel like it’s racing, pounding, or fluttering. Daytime sleepiness is one possible symptom of atrial fibrillation.

AFib can contribute to fatigue in several ways — through its effects on heart health, its link to sleep-disordered breathing, the medications used to treat it, and its potential to disrupt sleep.

Here’s how AFib can lead to daytime sleepiness.

The Link Between AFib, Sleep Apnea, and Daytime Sleepiness

AFib and sleep apnea are strongly linked. Scientists aren’t sure exactly how these conditions influence one another other, but many believe it has to do with how breathing issues during sleep affect the heart.

Sleep apnea — a condition marked by short pauses in breathing during sleep — can cause AFib. In obstructive sleep apnea (OSA), the airway becomes partially or completely blocked when the throat muscles relax. In central sleep apnea (CSA), the brain can’t activate the breathing muscles properly.

If you have untreated sleep apnea, your body will jolt you awake if you stop breathing and your oxygen levels drop. This is a survival reflex, and it can happen many times per hour, preventing you from entering deep sleep.

People with sleep apnea are often unable to get the restful sleep they need, which can lead to excessive daytime sleepiness.

Around 80 percent of people in the U.S. with sleep apnea are unaware of their condition. People with untreated sleep apnea usually have lower oxygen levels and more disrupted sleep than those who are on treatment. This makes them more likely to develop high blood pressure and other heart-related issues.

Research has also shown that people with AFib tend to be diagnosed with sleep apnea more often than those without the arrhythmia. Studies have reported that 21 percent to 74 percent of those with AFib also have OSA.

The two conditions share risk factors, including:

• Obesity
• Heart failure
• High blood pressure
• Older age
• High alcohol intake

Can AFib Medications Cause Drowsiness?

Untreated AFib can lead to heart failure, stroke, and other complications. The aim of an AFib treatment plan is to help your heart beat normally and reduce the occurrence of blood clots.

One way to treat AFib is by taking medications, some of which can contribute to drowsiness. Doctors may prescribe AFib medications to help regulate the speed and rhythm at which your heart beats.

Common treatment options include:

• Beta-blockers
• Calcium channel blockers
• Digoxin
• Antiarrhythmic drugs
• Blood thinners

You may need more than one medication to manage your AFib.

Beta-Blockers

Beta-blockers are the type of AFib medication most likely to cause tiredness. Beta-blockers are used to slow down your heart. A low heart rate can make you feel tired and have less energy.

Tiredness or fatigue were reported in around 10 percent of people who took beta-blockers. If you experience this side effect, your doctor may suggest trying a different beta-blocker or lowering your dose.

Other Medications

Sotalol is a combination of a beta-blocker and an antiarrhythmic. At lower doses, it acts like a beta-blocker and can lead to similar side effects, such as fatigue and tiredness. Other possible side effects include cold hands and feet, worsening asthma, and lightheadedness.

Calcium channel blockers can make you feel sleepy if they lower your blood pressure too much. Amiodarone, an antiarrhythmic, can lead to severe tiredness if it affects your thyroid function. That is why people who take amiodarone need to check their thyroid levels regularly.

Talk to your healthcare provider about the possible side effects of AFib medications.

How To Manage Daytime Sleepiness

In order to manage daytime sleepiness, you’ll need to figure out what’s causing it.

Identify and Treat Any Sleep Disorders

Your doctor may recommend seeing a sleep medicine specialist to help find the root cause of your fatigue. They may ask you to complete a sleep study, keep a sleep journal, or wear a monitor to track your sleep.

Sleep studies are commonly used to diagnose sleep apnea. If your sleepiness is found to be caused by sleep apnea, treating it can help you sleep better and feel more rested during the day.

If you have sleep apnea, using a continuous positive airway pressure (CPAP) machine or oral device may help improve your sleep quality.

Lifestyle adjustments may also help you sleep better and feel more awake. Some things to try:

• Exercising regularly
• Losing excess weight
• Sleeping on your side instead of your back
• Avoiding alcohol and smoking

Review Your Medications

Some AFib medications can make you feel sleepy, but many other medications can also lead to tiredness. Feeling a little tired when you first start taking an AFib medication is often temporary — your body may need time to adjust to the new drug.

If fatigue is impacting your quality of life, talk to your doctor. This is especially important if tiredness comes along with any of the following symptoms:

• Bradycardia (a heart rate below 60 beats per minute)
• Blood pressure lower than 90/60 mm Hg
• Chest pain
• Lightheadedness
• Shortness of breath

If an AFib treatment or another medication is causing your tiredness, your doctor may suggest trying a different medication or adjusting your dose.

Improve Your Sleep Hygiene

The habits you have around bedtime can make it easier — or harder — for you to get a good night’s sleep. These habits are often referred to as sleep hygiene.

Healthy lifestyle habits that can improve sleep hygiene include:

• Going to bed and waking up around the same time every day
• Choosing a calming activity before bed — like gentle yoga, reading, meditating, or taking a bath — rather than using a screen
• Keeping the lighting dim and your room cool
• Making your bed as comfortable as possible

Some habits can make it harder to sleep well. To get the best sleep, avoid napping during the day and limit caffeine, alcohol, and exercise later in the day.

Join the Conversation

On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

If you have AFib, do you often feel tired during the day? Let others know in the comments below.