Patrick L Stafford1, Evan Harmon2, Paras Patel3, McCall Walker4, Nazem Akoum5, Seung-Jung Park6, Yeilim Cho5, Kenneth Bilchick3, Nishaki Mehta7, Sula Mazimba3, Yoonsik Cho8, Younghoon Kwon5. 1. Department of Medicine, University of Virginia, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908, USA. pls2b@virginia.edu. 2. Department of Medicine, Cleveland Clinic, Cleveland, OH, USA. 3. Department of Medicine, University of Virginia, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908, USA. 4. Department of Medicine, University of Texas - Southwestern, Dallas, TX, USA. 5. Department of Medicine, University of Washington, Seattle, WA, USA. 6. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 7. Department of Cardiology, William Beaumont Hospital, Oakland University School of Medicine, Royal Oak, MI, USA. 8. Department of Artificial Intelligence, Chung-Ang University, Seoul, Republic of Korea.
Abstract
PURPOSE: Obstructive sleep apnea (OSA) is a common, potentially modifiable condition implicated in the pathogenesis of atrial fibrillation (AF). The presence and severity of OSA is largely sleep position-dependent, yet there is high variability in positional dependence among patients with OSA. We investigated the prevalence of positional OSA (POSA) and examined associated factors in patients with AF. METHODS: We recruited an equal number of patients with and without AF who underwent diagnostic polysomnography. Patients included had ≥ 120 min of total sleep time with 30 min of sleep in both supine and lateral positions. POSA was defined as an overall apnea hypopnea index (AHI) ≥ 5/h, supine AHI (sAHI) ≥ 5/h, and sAHI greater than twice the non-supine AHI. POSA prevalence was compared in patients with and without AF adjusting for age, sex, OSA severity, and heart failure. RESULTS: A total of patients (male: 56%, mean age 62 years) were included. POSA prevalence was similar between the two groups (46% vs. 39%; p = 0.33). Obesity and severe OSA (AHI ≥ 30/h) were associated with low likelihood of POSA (OR [CI] of 0.17 [0.09-0.32] and 0.28 [0.12-0.62]). In patients with AF, male sex was associated with a higher likelihood of POSA (OR [CI] of 3.16 [1.06-10.4]). CONCLUSION: POSA is common, affecting more than half of patients with AF, but the prevalence was similar in those without AF. Obesity and more severe OSA are associated with lower odds of POSA. Positional therapy should be considered in patients with mild OSA and POSA.
PURPOSE: Obstructive sleep apnea (OSA) is a common, potentially modifiable condition implicated in the pathogenesis of atrial fibrillation (AF). The presence and severity of OSA is largely sleep position-dependent, yet there is high variability in positional dependence among patients with OSA. We investigated the prevalence of positional OSA (POSA) and examined associated factors in patients with AF. METHODS: We recruited an equal number of patients with and without AF who underwent diagnostic polysomnography. Patients included had ≥ 120 min of total sleep time with 30 min of sleep in both supine and lateral positions. POSA was defined as an overall apnea hypopnea index (AHI) ≥ 5/h, supine AHI (sAHI) ≥ 5/h, and sAHI greater than twice the non-supine AHI. POSA prevalence was compared in patients with and without AF adjusting for age, sex, OSA severity, and heart failure. RESULTS: A total of patients (male: 56%, mean age 62 years) were included. POSA prevalence was similar between the two groups (46% vs. 39%; p = 0.33). Obesity and severe OSA (AHI ≥ 30/h) were associated with low likelihood of POSA (OR [CI] of 0.17 [0.09-0.32] and 0.28 [0.12-0.62]). In patients with AF, male sex was associated with a higher likelihood of POSA (OR [CI] of 3.16 [1.06-10.4]). CONCLUSION: POSA is common, affecting more than half of patients with AF, but the prevalence was similar in those without AF. Obesity and more severe OSA are associated with lower odds of POSA. Positional therapy should be considered in patients with mild OSA and POSA.
Authors: Dai Yumino; Hanqiao Wang; John S Floras; Gary E Newton; Susanna Mak; Pimon Ruttanaumpawan; John D Parker; T Douglas Bradley Journal: J Card Fail Date: 2009-01-21 Impact factor: 5.712
Authors: Dimpi Patel; Prasant Mohanty; Luigi Di Biase; Mazen Shaheen; William R Lewis; Kara Quan; Jennifer E Cummings; Paul Wang; Amin Al-Ahmad; Preeti Venkatraman; Eyad Nashawati; Dhanunjaya Lakkireddy; Robert Schweikert; Rodney Horton; Javier Sanchez; Joseph Gallinghouse; Steven Hao; Salwa Beheiry; Deb S Cardinal; Jason Zagrodzky; Robert Canby; Shane Bailey; J David Burkhardt; Andrea Natale Journal: Circ Arrhythm Electrophysiol Date: 2010-08-05
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: J Arrhythm Date: 2017-09-15
Authors: Ken Monahan; Jordan Brewster; Li Wang; Babar Parvez; Sandeep Goyal; Dan M Roden; Dawood Darbar Journal: Am J Cardiol Date: 2012-04-18 Impact factor: 2.778
Authors: Khin Mae Hla; Terry Young; Erika W Hagen; James H Stein; Laurel A Finn; F Javier Nieto; Paul E Peppard Journal: Sleep Date: 2015-05-01 Impact factor: 5.849