title: Efficacy of continuous positive airway pressure on arrhythmias in obstructive sleep apnea patients.
abstract: The purpose of this study was to determine the relationship between obstructive sleep apnea (OSA) and cardiovascular disorders in a large Japanese population, and to assess the efficacy of continuous positive airway pressure (CPAP) in the treatment of OSA-associated arrhythmias. The study population comprised 1394 Japanese subjects (1086 men and 308 women) who were divided into four groups on the basis of polysomnography (PSG) analysis as follows: the no sleep apnea (N-SA) group (n = 44, apnea-hypopnea index [AHI] < 5), the mild OSA (Mi-OSA) group (n = 197, 5 < AHI < 15), the moderate OSA (Mo) group (n = 368, 15 < AHI < 30), and severe OSA (SOSA) group (n = 785, AHI < 30). The following baseline characteristics were significantly associated with OSA: age (P < 0.001), gender (P < 0.001), body mass index (P < 0.001), hypertension (P < 0.001), diabetes (P = 0.009), and hyperlipidemia (P = 0.013). In the OSA group, PSG revealed the predominance of paroxysmal atrial fibrillation (PAF) (P = 0.051), premature atrial complex short run (P < 0.005), premature ventricular complex (PVC, P = 0.004), sinus bradycardia (P = 0.036), and sinus pause (arrest >2 s, P < 0.001) during the PSG recording. A total of 316 patients from the group underwent CPAP titration and were then re-evaluated. Continuous positive airway pressure therapy significantly reduced the occurrences of PAF (P < 0.001), PVC (P = 0.016), sinus bradycardia (P = 0.001), and sinus pause (P = 0.004). The results of this study demonstrate a significant relationship between OSA and several cardiac disorders, and also demonstrate the efficacy of CPAP in preventing OSA-associated arrhythmias in a large population of Japanese patients.
authors.affiliation: Division of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Abe
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Yaegashi
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Eda
authors.forename: Hideo
authors.initials: H
authors.lastname: Tsunemoto
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kamikozawa
authors.forename: Jun
authors.initials: J
authors.lastname: Koyama
authors.forename: Kyohei
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Uichi
authors.initials: U
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D044466:Asian People; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000208:ethnology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult