This review illustrates the importance of sleep disordered breathing in evolution and progression of atrial fibrillation. While in early years associations were mainly attributed to the impact of hypoxemia and hypertension, nowadays multiple, additional pathways have been investigated or are currently under investigation. Sleep disordered breathing has been shown to have a direct impact on mechanical and electrical remodeling. In addition hypercapnia and negative intrathoracic pressure seem to alter atrial electrophysiology. Finally, impacts on inflammation and metabolic dysregulationdisplay the complex interplay between breathing disorders and evolution and progression of atrial fibrillation.