Sleep with the Rhythm of your Heart

Arrhythmias during sleep are often detected on routine cardiac monitoring. Specialist cardiology opinion and input is often sought in order to assess whether nocturnal arrhythmias are clinically relevant or not. For the most part, bradyarrhythmias in the young fit individual are a variation of normal and require no further investigations. However even in normal sleep there are cardiovascular diseases that predispose patients to malignant arrhythmias, including heart failure, coronary heart disease and certain cardiac channelopathies. Primary sleep disorders such as obstructive sleep apnoea and alterations in sleep patterns during shift work have also been shown to have a proarrhythmogenic effect. This review aims to provide the reader with a broad overview of which arrhythmias are simply a reflection of normal changes in cardiac physiology during sleep, and which abnormal potentially dangerous arrhythmias require referral and treatment.