Obstructive sleep apnea and nocturnal attacks of paroxysmal atrial fibrillation.

Autor:	Lin CH; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.; Division of Respiratory Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan., Timofeeva M; Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada., O'Brien T; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada., Lyons OD; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.; Women's College Research Institute, Toronto, Ontario, Canada.; The Sleep Research Laboratory of UHN-TRI KITE, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2022 May 01; Vol. 18 (5), pp. 1279-1286.
DOI:	10.5664/jcsm.9840
Abstrakt:	Study Objectives: Obstructive sleep apnea (OSA) is commonly seen in patients with atrial fibrillation (AF), but it is unclear to what extent this relationship is one of causation or association. We examined a cohort of patients with paroxysmal AF to determine whether the presence of OSA (apnea-hypopnea index ≥ 15 events/h) affects the time of onset of symptomatic AF episodes. Methods: Patients with a recent emergency department visit for a symptomatic episode of paroxysmal AF were recruited from an AF clinic. The time of onset of the AF attack was classified as occurring in "sleeping hours" or "waking hours" based on direct history from the patient and emergency department visit documentation. Results: Of 152 patients with paroxysmal AF, 67 underwent polysomnography; 1 (1.5%) had central sleep apnea, 46 (68.7%) had mild or no OSA, and 20 (29.8%) had OSA. In the OSA group, 14/20 (70.0%) had their symptomatic AF attack during sleeping hours compared to 12/46 (26.1%) in the mild or no OSA group ( P = .001). Compared with those who had a paroxysmal AF attack during waking hours, and adjusting for confounders, those who had a paroxysmal AF attack during sleeping hours had almost 6 times the odds of having OSA (odds ratio, 5.53; P = .007). Conclusions: Compared to patients with paroxysmal AF with mild or no OSA, those with OSA were far more likely to have a symptomatic AF attack during sleeping hours, supporting a causal role for OSA in the pathogenesis of AF in this population. These findings strongly suggest that patients who have nocturnal AF attacks should be evaluated for OSA. Citation: Lin C-H, Timofeeva M, O'Brien T, Lyons OD. Obstructive sleep apnea and nocturnal attacks of paroxysmal atrial fibrillation. J Clin Sleep Med. 2022;18(5):1279-1286. (© 2022 American Academy of Sleep Medicine.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu