If you’ve ever been told you stop breathing in your sleep, you may wonder what that means for your heart. Sleep apnea and bradycardia (low heart rate) can be connected. This is because repeated pauses in breathing may lower oxygen levels and briefly change the way your heart beats during the night.

That doesn’t mean everyone with sleep apnea has a dangerous heart rhythm problem. It also doesn’t mean every slow heart rate is caused by sleep apnea.

But if you have symptoms like loud snoring, daytime sleepiness, dizziness, fainting, or nighttime heart palpitations, it’s worth bringing them up with a doctor.

Can Sleep Apnea Slow Your Heart Rate?

Yes, it can. Sleep apnea can affect your heart in several ways.

Sleep apnea causes repeated pauses in breathing during sleep. These pauses can lower oxygen levels and stress the body. Over time, that can raise blood pressure and put extra strain on the heart. In some people, this can cause heart rhythm changes, including bradycardia (low heart rate).

These heart rhythm changes may happen because of:

• Low oxygen levels — Oxygen drops can affect the heart’s electrical system.
• Stress hormone surges — Waking repeatedly can trigger adrenaline-like stress signals.
• Pressure changes in the chest — Trying to breathe through a blocked airway strains the heart and blood vessels.
• Inflammation and nervous system imbalance — Over time, sleep apnea may change how the body regulates your heart rhythm.

What Is Bradycardia?

Bradycardia means a heart rate below 60 beats per minute. For reference, a normal heart rate for most adults at rest is around 60 to 100 beats per minute.

During sleep, your heart rate normally slows down. But with sleep apnea, the changes can be more dramatic and may happen again and again throughout the night.

Not everyone with sleep apnea will have an abnormal heart rhythm. Cardiology guidelines say doctors should consider screening for sleep apnea when someone has nighttime bradycardia.

What Does Research Say About Sleep Apnea and Bradycardia?

Research suggests that sleep apnea and bradycardia often occur together.

A 2022 comprehensive review found that 56.8 percent of people with bradycardia had obstructive sleep apnea (OSA). It also found that, among people with OSA, 69.8 percent had nighttime bradycardia and 25 percent had daytime bradycardia.

Those numbers may seem high, but they should be read with caution. The included studies didn’t always measure bradycardia the same way, making results harder to compare.

While researchers can say there’s a strong association between sleep apnea and bradycardia, they can’t necessarily say with certainty that sleep apnea is the main cause.

Could Bradycardia Be Caused by Something Else?

A slow heart rate is not always caused by sleep apnea. Some people naturally have a low resting heart rate, especially younger adults and trained athletes.

Other causes of bradycardia can include:

• Aging-related changes in the heart
• Certain medications, such as beta-blockers
• Electrolyte problems
• Thyroid disease
• Infections or other heart conditions

That’s why it’s important not to assume sleep apnea is the only explanation. If you’ve noticed your heart has started beating more slowly or other new or worsening symptoms, a healthcare provider can help sort out what’s behind them.

What Symptoms Should You Watch For?

Sleep apnea symptoms and heart rhythm symptoms can overlap. Some people first notice the problem because a partner hears loud snoring or pauses in breathing.

Signs of Sleep Apnea

Symptoms of OSA can include:

• Loud snoring
• Pauses in breathing during sleep
• Waking up gasping or choking
• Waking to use the bathroom often
• Feeling very sleepy during the day
• Morning headaches
• Brain fog
• Mood changes and irritability
• Continued high blood pressure despite medication

Signs of Bradycardia

Many people with bradycardia don’t have any symptoms, but symptoms can include:

• Feeling dizzy or lightheaded
• Fainting
• Shortness of breath
• Chest pain
• Confusion or trouble focusing
• Excessive fatigue (tiredness)
• Heart palpitations

When Should You Seek Urgent Care?

Call emergency services right away if you have a low heart rate along with:

• Chest pain
• Trouble breathing
• Severe dizziness
• Fainting

Emergency care is also important if your heart rate drops below 40 beats per minute (if that’s not your usual heart rate).

For milder symptoms like loud snoring, gasping, pauses in breathing during sleep, or daytime sleepiness, make an appointment with your regular doctor.

How Is Sleep Apnea-Related Bradycardia Diagnosed?

If your doctor suspects you have bradycardia, testing may include:

• Electrocardiogram (ECG or EKG) — A quick test that records the heart’s electrical signals
• Holter monitor — A portable ECG worn for a day or more
• Event monitor — A device used for longer-term rhythm tracking when symptoms come and go
• Blood tests — To check for causes such as infection, thyroid problems, or electrolyte changes
• Tilt table test — Compares heart rate and blood pressure when lying down versus standing in people with a history of fainting

These tests can help rule out other causes of bradycardia besides sleep apnea. A sleep study, also called polysomnography, can confirm if bradycardia is related to sleep apnea. This test can track breathing, oxygen levels, heart rate, and brain activity during sleep.

It may also help to keep track of symptoms. Write down things like snoring, waking up gasping, dizziness, fainting, or palpitations. A symptom record can make it easier for your doctor to decide whether you need a sleep study, heart monitoring, or both.

What Treatments Can Help?

If bradycardia is related to sleep apnea, the first step is treating the sleep apnea itself. Successfully treating sleep apnea can often help people avoid the need for a pacemaker, a common treatment for severe bradycardia.

The most common treatment for OSA is continuous positive airway pressure (CPAP). It uses gentle air pressure to keep the airway open during sleep, which can prevent breathing pauses and improve daytime sleepiness and quality of life.

One study found that in 80 percent of participants with OSA and severe bradycardia, the bradycardia got better with CPAP therapy.

Unfortunately, some people have trouble using a CPAP machine. Other sleep apnea treatments may include:

• Other positive airway pressure devices
• Oral appliances
• Surgery
• Nerve stimulation implant
• Weight loss medications or surgery (for people with obesity)

What Lifestyle Tips May Support Sleep Apnea and Heart Health?

Lifestyle changes won’t replace medical care, but they can help support treatment and may help improve sleep apnea symptoms.

Here are some lifestyle tips you can try:

• Sleeping on your side — This may help keep the airway from becoming blocked during sleep.
• Avoiding alcohol close to bedtime — Alcohol can relax the muscles in the throat and make breathing problems during sleep worse.
• Prioritizing weight loss and regular exercise — For people who are overweight or have been diagnosed with obesity, weight loss may help reduce sleep apnea symptoms. Regular exercise can also support better sleep and overall heart health.

Many people with sleep apnea aren’t aware of the effect it can have on the heart and overall health.

One MySleepApneaTeam member stated, “I can’t believe what sleep apnea can do to you health-wise.” Several team members reported getting serious about treatment after learning this information.

Join the Conversation

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

Have you been diagnosed with bradycardia in addition to sleep apnea? Let others know in the comments below.