title: Sleep-disordered breathing and chronic atrial fibrillation.
abstract: BACKGROUND
  Little has been known about the prevalence of sleep apnea in patients with atrial fibrillation (AF). Studies have suggested that the prevalence of AF is increasing in patients with sleep-disordered breathing. We hypothesize that the prevalence of OSA is higher in chronic persistent and permanent AF patients than a sub-sample of the general population without this arrhythmic disorder.
  
  
  OBJECTIVE
  Evaluate the frequency of Obstructive Sleep Apnea in a sample of chronic AF compared to a sub-sample of the general population.
  
  
  METHODS
  Fifty-two chronic AF patients aged (60.5 +/- 9.5, 33 males) and 32 control (aged 57.3 +/- 9.6, 15 males). All subjects were evaluated by a staff cardiologist for the presence of medical conditions and were referred for polysomnography. The differences between groups were analyzed by ANOVA for continuous variables, and by the Chi-square test for dichotomous variables. Statistical significance was established by alpha=0.05.
  
  
  RESULTS
  There were no differences in age, gender, BMI, sedentarism, presence of hypertension, type 2 diabetes mellitus, abdominal circumference, systolic and diastolic blood pressure, and sleepiness scoring between groups. Despite similar BMI, AF patients had a higher neck circumference compared to control group (39.9cm versus 37.7cm, p=0.01) and the AF group showed higher percentage time of stage 1 NREM sleep (6.4% versus 3.9%, p=0.03). Considering a cut-off value for AHI >= 10 per hour of sleep, the AF group had a higher frequency of OSA compared to the control group (81.6% versus 60%, p=0.03). All the oxygen saturation parameters were significantly worse in the AF group, which had lower SaO(2) nadir (81.9% versus 85.3%, p=0.01) and mean SaO(2) (93.4% versus 94.3%, p=0.02), and a longer period of time below 90% (26.4min versus 6.7min, p=0.05).
  
  
  CONCLUSIONS
  Sleep-disordered breathing is more frequent in chronic persistent and permanent AF patients than in age-matched community dwelling subjects.
authors.affiliation: Sleep Institute, Psychobiology Department, Universidade Federal de Sao Paulo, Rua Marselhesa 524, Vila Clementino, Sao Paulo, SP, Brazil; Cardiology Section, Universidade Federal de Sao Paulo, Brazil. betabs@ig.com.br
authors.forename: B
authors.initials: B
authors.lastname: Braga
authors.forename: D
authors.initials: D
authors.lastname: Poyares
authors.forename: F
authors.initials: F
authors.lastname: Cintra
authors.forename: C
authors.initials: C
authors.lastname: Guilleminault
authors.forename: C
authors.initials: C
authors.lastname: Cirenza
authors.forename: S
authors.initials: S
authors.lastname: Horbach
authors.forename: D
authors.initials: D
authors.lastname: Macedo
authors.forename: R
authors.initials: R
authors.lastname: Silva
authors.forename: S
authors.initials: S
authors.lastname: Tufik
authors.forename: A A V
authors.initials: AA
authors.lastname: De Paola
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D015992:Body Mass Index; D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*