Cardiac Rhythm Disorders in Patients with Obstructive Sleep Apnea

BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent but often underdiagnosed sleep disorder associated with intermittent hypoxia and fragmented sleep. It has been increasingly implicated in the pathogenesis of cardiac rhythm disorders (CRDs), including atrial fibrillation (AF), bradyarrhythmia's, and ventricular arrhythmias. Despite substantial global evidence, limited Indian data exist regarding the burden and characteristics of CRDs among OSA patients. OBJECTIVE: The objective is to determine the prevalence and types of CRD in patients diagnosed with OSA and explore their correlation with OSA severity and clinical-demographic factors. METHODS: A cross-sectional observational study was conducted at a tertiary care center in Pune over 1½. Fifty adult patients diagnosed with OSA by polysomnography (PSG) (apnea-hypopnea index [AHI] ≥5) underwent 24-h Holter monitoring to assess cardiac rhythm abnormalities. Data on demographic profile, comorbidities, STOP-BANG and Epworth Sleepiness Scale scores, and PSG parameters were collected and analyzed. RESULTS: The mean age was 61.2 ± 11.5 years, and 64% were male. Obesity was present in 72% of participants. Severe OSA was seen in 56%, moderate in 28%, and mild in 16%. Sinus tachycardia (24%) and AF (12%) were the most common, followed by sinus bradycardia (10%) and premature ventricular contractions (8%). CRDs were significantly associated with OSA severity (P < 0.001), high STOP-BANG and ESS scores, and systemic hypertension. CONCLUSION: Nearly half of the OSA patients exhibited cardiac rhythm abnormalities, with higher OSA severity correlating with increased arrhythmias. Early cardiac evaluation in OSA patients may aid in mitigating cardiovascular risk.