Associations of sleep quality with incident atrial fibrillation: a meta‐analysis

Chokesuwattanaskul, Ronpichai; Thongprayoon, Charat; Sharma, Konika; Congrete, Soontharee; Tanawuttiwat, Tanyanan; Cheungpasitporn, Wisit

doi:10.1111/imj.13764

Cited by 47 publications

(24 citation statements)

References 53 publications

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“…This finding therefore does not support the use of HAVOC score to exclude patients at the lower end of risk spectrum for consideration of ICMs. Most importantly, though, it highlights the concept that there may be non-traditional AF risk factors that do not fit into the conventional atherothrombosis-centric paradigm 31 : familial aggregation, ethnic differences, genetics, 32 excess physical activity/endurance training, 33,34 insomnia and frequent night-time awaking, 35 alcoholism and substance abuse, 36,37 to name just a few. In addition, psychological factors such as anxiety, depression, and certain personality traits have been suggested to influence AF onset, progression, severity, and outcomes, but their role is far from clear.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a clinical score for predicting atrial fibrillation in cryptogenic stroke patients with insertable cardiac monitors: results from the CRYSTAL AF study

Zhao

Ziegler

Crawford

et al. 2019

Ther Adv Neurol Disord

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Background: The HAVOC score was previously developed to predict the risk of atrial fibrillation (AF) after cryptogenic stroke (CS) or transient ischemic attack (TIA). The purpose of this study was to apply the HAVOC score to patients who received insertable cardiac monitors (ICMs) in the CRYSTAL AF study. Methods: All patients from the CRYSTAL AF study who received an ICM were included. HAVOC score (one point each for peripheral vascular disease and obesity with body mass index >30, two points each for hypertension, age ⩾ 75, valvular heart disease, and coronary artery disease, 4 points for congestive heart failure) was computed for all patients. The primary endpoint was AF detection by 12 months of ICM monitoring. Results: A total of 214 patients who received ICM were included. AF was detected in 40 patients while the remaining 174 patients were AF negative. The HAVOC score was significantly higher among patients with AF [median 3.0 with interquartile range (IQR) 2–4] than those without AF [median 2.0 (IQR 0–3)], p = 0.01. AF increased significantly across the three HAVOC score groups: 11% in Group A (score 0–1), 18% in Group B (score 2–3), and 32 % in Group C (score ⩾ 4) with p = 0.02. Conclusions: The HAVOC score was shown in this post hoc analysis of CRYSTAL AF to successfully stratify AF risk post CS or TIA. The 11% AF rate in the lowest HAVOC score group highlights the significance of nontraditional contributors to AF and ischemic stroke.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a clinical score for predicting atrial fibrillation in cryptogenic stroke patients with insertable cardiac monitors: results from the CRYSTAL AF study

Zhao

Ziegler

Crawford

et al. 2019

Ther Adv Neurol Disord

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“…We included observational studies only; therefore, our analysis has demonstrated an association but not causality. In addition, the data on sleep quality, which may play an important role in AF development, were limited. Lastly, since atrial enlargement has been previously identified as a risk factor for the recurrences, future studies with a large population are needed to assess the efficacy of CPAP on reversal the structural changes of the atrium, as an underlying mechanism reducing the risk for AF recurrence after ablation.…”

Section: Discussionmentioning

confidence: 99%

Effect of obstructive sleep apnea and its treatment of atrial fibrillation recurrence after radiofrequency catheter ablation: A meta‐analysis

Congrete

Bintvihok

Thongprayoon

et al. 2018

J Evidence Based Medicine

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“…Yet , it is possible that differences in HF or comorbidity between CBT-I and attention-control groups or unmeasured differences in HF contributed to our findings.. Other HF and cardiovascular characteristics (e.g., dysrhythmias) should be considered in more detail in future studies. For example, recent evidence suggest that atrial fibrillation contributes to insomnia (Chokesuwattanaskul et al, 2018;Christensen et al, 2018;Han et al, 2017;Lee et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Effects of Cognitive Behavioral Therapy for Insomnia on Sleep, Symptoms, Stress, and Autonomic Function Among Patients With Heart Failure

Redeker¹,

Conley

Anderson³

et al. 2018

Behavioral Sleep Medicine

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Background: Insomnia is common among patients with stable heart failure (HF) and associated with inflammation and altered autonomic function. Purpose: The purposes of this study were to examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on the Hypothalamic Pituitary (HPA) Axis, autonomic function, inflammation and circadian rhythmicity and the associations between these biomarkers and insomnia, sleep characteristics, symptoms, functional performance, and sleep-related cognitions. Methods: We conducted a sub-analysis of a pilot randomized controlled trial (RCT) (NCT02827799) whose primary aim was to test the effects of CBT-I on insomnia. We randomized 51 patients with stable Class II-IV HF to CBT-I (n = 30) or attention control (n = 21). Participants completed wrist actigraphy and self-reported insomnia severity, sleep characteristics, sleep-related cognitions, daytime symptoms, and functional performance. We measured day and nighttime urinary free cortisol, melatonin sulfate, epinephrine and norepinephrine at baseline and 2 weeks after CBT-I and computed general linear models and partial correlations. Results: CBT-I had no effects on the biomarkers, but there were statistically significant negative cross-sectional correlations between the ratio of day/night urinary free cortisol and sleep

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Associations of sleep quality with incident atrial fibrillation: a meta‐analysis

Abstract: Our findings suggest an absence in association between AF and sleep duration but reveal the potential association between AF and both insomnia and frequent nocturnal awakening. As such, the further studies on association of AF and sleep qualities are warranted.

Cited by 47 publications

References 53 publications

Evaluation of a clinical score for predicting atrial fibrillation in cryptogenic stroke patients with insertable cardiac monitors: results from the CRYSTAL AF study

Evaluation of a clinical score for predicting atrial fibrillation in cryptogenic stroke patients with insertable cardiac monitors: results from the CRYSTAL AF study

Effect of obstructive sleep apnea and its treatment of atrial fibrillation recurrence after radiofrequency catheter ablation: A meta‐analysis

Effects of Cognitive Behavioral Therapy for Insomnia on Sleep, Symptoms, Stress, and Autonomic Function Among Patients With Heart Failure

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