Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women
BackgroundPrevious studies have documented a high prevalence of atrial fibrillation (AF) in individuals with obstructive sleep apnea (OSA). Central sleep apnea (CSA) has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have dis...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004500 |
| _version_ | 1811329034063183872 |
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| author | Patricia Tung Yamini S. Levitzky Rui Wang Jia Weng Stuart F. Quan Daniel J. Gottlieb Michael Rueschman Naresh M. Punjabi Reena Mehra Suzie Bertisch Emelia J. Benjamin Susan Redline |
| author_facet | Patricia Tung Yamini S. Levitzky Rui Wang Jia Weng Stuart F. Quan Daniel J. Gottlieb Michael Rueschman Naresh M. Punjabi Reena Mehra Suzie Bertisch Emelia J. Benjamin Susan Redline |
| author_sort | Patricia Tung |
| collection | DOAJ |
| description | BackgroundPrevious studies have documented a high prevalence of atrial fibrillation (AF) in individuals with obstructive sleep apnea (OSA). Central sleep apnea (CSA) has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have distinguished the associations of obstructive sleep apnea from CSA with AF in population studies. Methods and ResultsWe assessed the association of obstructive sleep apnea and CSA with incident AF among 2912 individuals without a history of AF in the SHHS (Sleep Heart Health Study), a prospective, community‐based study of existing (“parent”) cohort studies designed to evaluate the cardiovascular consequences of sleep disordered breathing. Incident AF was documented by 12‐lead ECG or assessed by the parent cohort. obstructive sleep apnea was defined by the obstructive apnea‐hypopnea index (OAHI). CSA was defined by a central apnea index ≥5 or the presence of Cheyne Stokes Respiration. Logistic regression was used to assess the association between sleep disordered breathing and incident AF. Over a mean of 5.3 years of follow‐up, 338 cases of incident AF were observed. CSA was a predictor of incident AF in all adjusted models and was associated with 2‐ to 3‐fold increased odds of developing AF (central apnea index ≥5 odds ratio [OR], 3.00, 1.40–6.44; Cheyne–Stokes respiration OR, 1.83, 0.95–3.54; CSA or Cheyne–Stokes respiration OR, 2.00, 1.16–3.44). In contrast, OAHI was not associated with incident AF (OAHI per 5 unit increase OR, 0.97, 0.91–1.03; OAHI 5 to <15 OR, 0.84, 0.59–1.17; OAHI 15 to <30 OR, 0.93, 0.60–1.45; OAHI ≥30 OR, 0.76, 0.42–1.36). ConclusionsIn a prospective, community‐based cohort, CSA was associated with incident AF, even after adjustment for cardiovascular risk factors. |
| first_indexed | 2024-04-13T15:36:40Z |
| format | Article |
| id | doaj.art-6d39f294ae654cc59d691e43cc62708d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T15:36:40Z |
| publishDate | 2017-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-6d39f294ae654cc59d691e43cc62708d2022-12-22T02:41:16ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-07-016710.1161/JAHA.116.004500Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and WomenPatricia Tung0Yamini S. Levitzky1Rui Wang2Jia Weng3Stuart F. Quan4Daniel J. Gottlieb5Michael Rueschman6Naresh M. Punjabi7Reena Mehra8Suzie Bertisch9Emelia J. Benjamin10Susan Redline11Division of Cardiology, Atrius Health, Boston, MADivision of Cardiology, Newton‐Wellesley Hospital, Newton, MADivision of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MADivision of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MADivision of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MADivision of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MADivision of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MAJohns Hopkins University School of Medicine, Baltimore, MDSleep Center, Neurologic Institute, Cleveland Clinic, Cleveland, OHDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MABoston University School of Medicine, Boston, MADivision of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MABackgroundPrevious studies have documented a high prevalence of atrial fibrillation (AF) in individuals with obstructive sleep apnea (OSA). Central sleep apnea (CSA) has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have distinguished the associations of obstructive sleep apnea from CSA with AF in population studies. Methods and ResultsWe assessed the association of obstructive sleep apnea and CSA with incident AF among 2912 individuals without a history of AF in the SHHS (Sleep Heart Health Study), a prospective, community‐based study of existing (“parent”) cohort studies designed to evaluate the cardiovascular consequences of sleep disordered breathing. Incident AF was documented by 12‐lead ECG or assessed by the parent cohort. obstructive sleep apnea was defined by the obstructive apnea‐hypopnea index (OAHI). CSA was defined by a central apnea index ≥5 or the presence of Cheyne Stokes Respiration. Logistic regression was used to assess the association between sleep disordered breathing and incident AF. Over a mean of 5.3 years of follow‐up, 338 cases of incident AF were observed. CSA was a predictor of incident AF in all adjusted models and was associated with 2‐ to 3‐fold increased odds of developing AF (central apnea index ≥5 odds ratio [OR], 3.00, 1.40–6.44; Cheyne–Stokes respiration OR, 1.83, 0.95–3.54; CSA or Cheyne–Stokes respiration OR, 2.00, 1.16–3.44). In contrast, OAHI was not associated with incident AF (OAHI per 5 unit increase OR, 0.97, 0.91–1.03; OAHI 5 to <15 OR, 0.84, 0.59–1.17; OAHI 15 to <30 OR, 0.93, 0.60–1.45; OAHI ≥30 OR, 0.76, 0.42–1.36). ConclusionsIn a prospective, community‐based cohort, CSA was associated with incident AF, even after adjustment for cardiovascular risk factors.https://www.ahajournals.org/doi/10.1161/JAHA.116.004500arrhythmiaatrial fibrillationcohortobstructive sleep apneasleep apnea |
| spellingShingle | Patricia Tung Yamini S. Levitzky Rui Wang Jia Weng Stuart F. Quan Daniel J. Gottlieb Michael Rueschman Naresh M. Punjabi Reena Mehra Suzie Bertisch Emelia J. Benjamin Susan Redline Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arrhythmia atrial fibrillation cohort obstructive sleep apnea sleep apnea |
| title | Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women |
| title_full | Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women |
| title_fullStr | Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women |
| title_full_unstemmed | Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women |
| title_short | Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women |
| title_sort | obstructive and central sleep apnea and the risk of incident atrial fibrillation in a community cohort of men and women |
| topic | arrhythmia atrial fibrillation cohort obstructive sleep apnea sleep apnea |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004500 |
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