Prevalence of sleep apnea syndrome in lone atrial fibrillation: a case-control study.
BACKGROUND
According to several studies, obstructive sleep apnea predisposes to cardiac arrhythmias, but the prevalence of sleep apnea in specific arrhythmias has not been determined. Our case-control study assesses prevalence of sleep apnea syndrome (SAS) in lone atrial fibrillation (AF).


METHODS
Patients with AF (n = 59; 48 men and 11 women; mean age, 59 years; age range, 25 to 84 years) without evident cardiovascular diseases, and their 56 gender-matched, age-matched, and cardiovascular morbidity-matched community control subjects underwent an overnight sleep study.


RESULTS
Prevalence of SAS in the AF group was 32%, which did not differ from that in control subjects (29%, p = 0.67). In men, mean neck circumference was higher in the AF group (40.9 cm vs 39.5 cm, p = 0.01) than in control subjects. In men, after adjusting for body mass index and waist circumference, neck circumference was independently related to AF, with an odds ratio (OR) of 1.8 (95% confidence interval, 1.3 to 2.5) per 1-cm increase, and an OR of 5.2 (95% confidence interval, 1.6 to 17.0) for values > 40 cm. Compared to control subjects, the AF group reported more daily/almost-daily tiredness (29% vs 4%, p < 0.001), daily/almost-daily sleepiness (27% vs 7%, p = 0.005), and nightly/almost-nightly breathing pauses during sleep (12% vs 2%, p = 0.03).


CONCLUSIONS
SAS seems to be common in lone AF. Nevertheless, we could not show SAS to be more common in patients with AF than in gender-matched, age-matched, and cardiovascular morbidity-matched community control subjects. Compared to control subjects, men with AF seem to have thicker necks, and patients with lone AF report more daytime tiredness, daytime sleepiness, and breathing pauses during sleep.
Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. porthan@mappi.helsinki.fi
Kimmo Markus
KM
Porthan
John Henry
JH
Melin
Jukka Tapani
JT
Kupila
Kari Kauko Kalervo
KK
Venho
Markku Mikael
MM
Partinen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis