Nocturnal arrhythmias across a spectrum of obstructive and central sleep-disordered breathing in older men: Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study
Mehra R et al. – In a large cohort of older men, increasing severity of sleep-disordered breathing (SDB) was associated with a progressive increase in odds of atrial fibrillation or flutter (AF) and complex ventricular ectopy (CVE). When SDB was characterized by central or obstructive subtypes, CVE was associated most strongly with , obstructive sleep apnea (OSA) and hypoxia, whereas AF was most strongly associated with central sleep apnea (CSA), suggesting that different sleep-related stresses may contribute to atrial and ventricular arrhythmogenesis in older men. Methods- Study of the association between SDB with nocturnal AF and CVE in older men
- Unattended polysomnography for 2911 pts in Outcomes of Sleep Disorders in Older Men Study
- Electrocardiogram-specific analysis of polysomnographic data for nocturnal AF and CVE
- SDB defined by respiratory disturbance index (RDI) quartile (major index for all apneas and hypopneas)
- Ancillary definitions incorporating: 1) obstructive events (OSA; OSA Index quartile); 2) central events (CSA; Central Apnea Index category), and 3) hypoxia (percentage of sleep time with <90% arterial oxygen percent saturation)
Results- An increasing RDI quartile associated with increased odds of AF and CVE
- Highest RDI quartile associated with increased odds of AF and CVE vs lowest quartile
- Increasing OSA quartile significantly associated with increasing CVE but not AF
- Central sleep apnea more strongly associated with AF
- Hypoxia level associated with CVE; pts in highest hypoxia category had an increased odds of CVE vs lowest quartile
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