Severe sleep-disordered breathing was associated with increased odds of nocturnal atrial fibrillation (OR 2.15; 95% CI 1.19-3.89) and complex ventricular ectopy (OR 1.43; 95% CI 1.12-1.82).
Cohort (n=2,911)
Does increasing severity of sleep-disordered breathing increase the odds of nocturnal atrial fibrillation and complex ventricular ectopy in older men?
Increasing severity of sleep-disordered breathing is associated with higher odds of nocturnal atrial fibrillation and complex ventricular ectopy in older men, with central sleep apnea more strongly linked to AF and obstructive sleep apnea to CVE.
Effect estimate: OR 2.15 (95% CI 1.19-3.89)
p-value: p=.01
BACKGROUND: Rates of cardiac arrhythmias increase with age and may be associated with clinically significant morbidity. We studied the association between sleep-disordered breathing (SDB) with nocturnal atrial fibrillation or flutter (AF) and complex ventricular ectopy (CVE) in older men. METHODS: A total of 2911 participants in the Outcomes of Sleep Disorders in Older Men Study underwent unattended polysomnography. Nocturnal AF and CVE were ascertained by electrocardiogram-specific analysis of the polysomnographic data. Exposures were (1) SDB defined by respiratory disturbance index (RDI) quartile (a major index including all apneas and hypopneas), and ancillary definitions incorporating (2) obstructive events, obstructive sleep apnea (OSA; Obstructive Apnea Hypopnea Index quartile), or (3) central events, central sleep apnea (CSA; Central Apnea Index category), and (4) hypoxia (percentage of sleep time with <90% arterial oxygen percent saturation). Multivariable logistic regression analyses were performed. RESULTS: An increasing RDI quartile was associated with increased odds of AF and CVE (P values for trend, .01 and <.001, respectively). The highest RDI quartile was associated with increased odds of AF (odds ratio OR, 2.15; 95% confidence interval CI, 1.19-3.89) and CVE (OR, 1.43; 95% CI, 1.12-1.82) compared with the lowest quartile. An increasing OSA quartile was significantly associated with increasing CVE (P value for trend, .01) but not AF. Central sleep apnea was more strongly associated with AF (OR, 2.69; 95% CI, 1.61-4.47) than CVE (OR, 1.27; 95% CI, 0.97-1.66). Hypoxia level was associated with CVE (P value for trend, <.001); those in the highest hypoxia category had an increased odds of CVE (OR, 1.62; 95% CI, 1.23-2.14) compared with the lowest quartile. CONCLUSIONS: In this large cohort of older men, increasing severity of SDB was associated with a progressive increase in odds of AF and CVE. When SDB was characterized according to central or obstructive subtypes, CVE was associated most strongly with OSA and hypoxia, whereas AF was most strongly associated with CSA, suggesting that different sleep-related stresses may contribute to atrial and ventricular arrhythmogenesis in older men.
Mehra et al. (Mon,) conducted a cohort in Sleep-disordered breathing (n=2,911). Sleep-disordered breathing (highest RDI quartile) vs. Lowest RDI quartile was evaluated on Nocturnal atrial fibrillation or flutter (AF) (OR 2.15, 95% CI 1.19-3.89, p=.01). Severe sleep-disordered breathing was associated with increased odds of nocturnal atrial fibrillation (OR 2.15; 95% CI 1.19-3.89) and complex ventricular ectopy (OR 1.43; 95% CI 1.12-1.82).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: