Association Between Atrial Fibrillation and Central Sleep Apnea

Leung, Richard; Huber, Matthias A.; Rogge, Thomas; Maimon, Nimrod; Chiu, Kuo-Liang; Bradley, T. Douglas

doi:10.1093/sleep/28.12.1543

Cited by 110 publications

(52 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings were also consistent with previously published work which shows an association between SDB and conditions such as diabetes [17] and atrial fibrillation [18,19].…”

Section: Cardiovascular Morbiditysupporting

confidence: 94%

Morbidity and Predicted Mortality in Older Adults with Central Sleep Apnea

S¹,

Dauphinot

Gooneratne³

et al. 2013

J Sleep Disorders Ther

View full text Add to dashboard Cite

Brief SummaryCurrent knowledge/study rationale Sleep-Disordered Breathing (SDB) in general and Central Sleep Apnea (CSA) in particular are known to increase with advancing age. The information concerning the morbidity and mortality associated with CSA in older populations is scarce and inconsistent. It is not known if CSA-related mortality is greater than Obstructive Sleep Apnea (OSA) related mortality in the elderly. Study impactOur study using a prognostic mortality risk index demonstrates that CSA diagnosed by full polysomnography is a major and independent risk factor for mortality in older adults. Untreated CSA compared with OSA is also significantly associated with stroke and hypertension. IntroductionThe prevalence of Sleep-Disordered Breathing (SDB), defined as an Apnea-Hypopnea index (AHI) of 15 or greater, is 23% in the community-dwelling older over the age of 70 [1]. Central Sleep Apnea (CSA), a form of SDB, can affect more than one third of these elderly patients with SDB [1]. The prevalence, severity and costs of CSA will likely escalate as the older adult population increases in number and lives longer.CSA is characterized on the polysomnogram by recurrent cessation of respiration during sleep with no associated ventilatory effort. In contrast obstructive sleep apnea (OSA) is defined as repetitive episodes of upper airway obstruction with ongoing respiratory efforts [2]. In OSA patients the repetitive upper airway collapse occurs during sleep because negative pressure generated during inspiration is not effectively counteracted by splinting by pharyngeal dilators, especially when narrowing occurs as a result of excessive soft tissue (e.g. obesity, loss of soft tissue elasticity related to age) or vulnerable craniofacial anatomy (e.g. edentulous older adults). In both cases, the Continuous Positive Airway Pressure (CPAP) is the most widely used treatment even in older adults. Furthermore, bilevel positive airway pressure (BiPAP) in a spontaneous-timed mode and Adaptive Servo-Ventilation (ASV) which generates positive airway pressure with variable pressure in response to a patient's expiration are increasingly recommended in order to ameliorate central respiratory events related to chronic heart failure. AbstractObjectives: To assess cardiovascular morbidity and prognostic mortality risk in older patients with CSA in comparison to those with OSA and without any SDB (apnea-hypopnea index <15/hour).Background: Sleep-Disordered Breathing (SDB), including both Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA), is a prevalent condition in older adults. In contrast to OSA, the information concerning the morbidity and mortality associated with CSA is scarce and inconsistent.

show abstract

“…Our findings were also consistent with previously published work which shows an association between SDB and conditions such as diabetes [17] and atrial fibrillation [18,19].…”

Section: Cardiovascular Morbiditysupporting

confidence: 94%

Morbidity and Predicted Mortality in Older Adults with Central Sleep Apnea

S¹,

Dauphinot

Gooneratne³

et al. 2013

J Sleep Disorders Ther

View full text Add to dashboard Cite

show abstract

“…OSA has mainly been associated with premature atrial complex short runs, sinus bradycardia, sinus pauses, premature ventricular complexes and paroxysmal atrial fibrillation [9][10][11], while central sleep apnoea (CSA) has mainly been associated with atrial fibrillation [12]. There is also evidence for a close temporal relationship between arrhythmia and obstructive apnoeas [13].…”

mentioning

confidence: 99%

Effects of obstructive sleep apnoea on heart rhythm

2012

View full text Add to dashboard Cite

Symptomatic obstructive sleep apnoea (OSA) has been proven to be a risk factor for hypertension and vascular dysfunction, and has been proposed to be causally related with cardiac arrhythmias and sudden cardiac death.Searches of bibliographical databases revealed that several mechanisms seem to underpin the association between OSA and cardiac arrhythmias: intermittent hypoxia associated with autonomic nervous system activation and increased oxidative stress, which may lead to cardiac cellular damage and alteration in myocardial excitability; recurrent arousals, resulting in sympathetic activation and coronary vasoconstriction; and increased negative intrathoracic pressure which may mechanically stretch the myocardial walls and, thus, promote acute changes in myocardial excitability as well as structural remodelling of the myocardium.Findings from cross-sectional studies suggest a high prevalence of cardiac arrhythmias in patients with OSA and a high prevalence of OSA in those with cardiac arrhythmias. Preliminary evidence from uncontrolled interventional studies suggests that treatment of OSA may prevent cardiac arrhythmias.In conclusion, there is preliminary evidence that OSA is associated with the development of cardiac arrhythmias. Data from randomised controlled studies are needed to definitively clarify the role of OSA in arrhythmogenesis.

show abstract

“…The effect of hypoxia on atrial fibrillation, however, was not significant. Although these results were based on self-reported heart failure, the authors suggested that their results agree with those of Leung et al (2005), that atrial fibrillation is more strongly associated with CSA than OSA, even in the absence of heart failure. They concluded that it may be beneficial to screen patients with AF for CSA.…”

Section: Atrial Fibrillationmentioning

confidence: 60%

“…Requiring an AHI of at least 15 as diagnostic for OSA, a case control study failed to show a difference in OSA prevalence between 59 patients with lone atrial fibrillation (i.e., without chronic or acute risk factors) and controls who were age, gender, and co-morbidity matched controls (32% vs. 29%; P=0.67) (Porthan et al, 2004). Another study (Leung et al, 2005) that excluded patients with a history of congestive heart failure (CHF), CAD, or stroke, enrolled 60 patients each without SBD, with CSA, and with OSA. The prevalence of atrial fibrillation was significantly higher in patients with CSA (27%) compared with OSA (1.7%) or no SBD (3.3%; P<.001).…”

Section: Cardiac Arrhythmias In Community-based Studies and In Subjecmentioning

confidence: 99%

Sleep-Related Breathing Disorders and Cardiac Arrhythmia

Hersi¹

2012

Cardiac Arrhythmias - New Considerations

View full text Add to dashboard Cite

Association Between Atrial Fibrillation and Central Sleep Apnea

Cited by 110 publications

References 29 publications

Morbidity and Predicted Mortality in Older Adults with Central Sleep Apnea

Morbidity and Predicted Mortality in Older Adults with Central Sleep Apnea

Effects of obstructive sleep apnoea on heart rhythm

Sleep-Related Breathing Disorders and Cardiac Arrhythmia

Contact Info

Product

Resources

About