title: Cardioversion of atrial fibrillation does not affect obstructive sleep apnea.
abstract: BACKGROUND
  Sleep apnea is common in patients with atrial fibrillation, but the effect of the cardioversion of atrial fibrillation to sinus rhythm on central and obstructive apneas is mainly unknown. The primary aim of the study was to analyze the association between cardioversion of atrial fibrillation and sleep apneas, to investigate whether obstructive or central sleep apneas are reduced following cardioversion. A secondary objective was to study the effect on sleep quality.
  
  
  METHODS
  Twenty-three patients with atrial fibrillation were investigated using overnight polysomnography, including esophagus pressure monitoring and ECG, before and after the cardioversion of persistent atrial fibrillation.
  
  
  RESULTS
  Obstructive sleep apnea occurred in 17/23 patients (74%), and central sleep apnea in 6/23 patients (26%). Five patients had both obstructive and central sleep apnea. Sinus rhythm at follow-up was achieved in 16 patients. The obstructive apnea-hypopnea index, central apnea-hypopnea index, and the number of patients with obstructive or central sleep apnea did not differ before and after restoration of sinus rhythm. Sleep time, sleep efficiency, time in different sleep stages, and subjective daytime sleepiness were normal and unaffected by cardioversion.
  
  
  CONCLUSIONS
  Both obstructive and central sleep apneas are highly prevalent in patients with persistent atrial fibrillation. Obstructive sleep apneas are unaffected by the cardioversion of atrial fibrillation to sinus rhythm. The sleep pattern is normal and unaffected by cardioversion in patients with atrial fibrillation.
  
  
  BACKGROUND
  Trial number NCT00429884.
authors.affiliation: a Public Health and Clinical Medicine , Heart Centre, Umeå University , Umeå , Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Höglund
authors.affiliation: b Public Health and Clinical Medicine, Medicine , Umeå University , Umeå , Sweden.
authors.forename: Carin
authors.initials: C
authors.lastname: Sahlin
authors.affiliation: a Public Health and Clinical Medicine , Heart Centre, Umeå University , Umeå , Sweden.
authors.forename: Milos
authors.initials: M
authors.lastname: Kesek
authors.affiliation: a Public Health and Clinical Medicine , Heart Centre, Umeå University , Umeå , Sweden.
authors.forename: Steen M
authors.initials: SM
authors.lastname: Jensen
authors.affiliation: c Surgical and Perioperative Sciences, Surgery , Umeå University , Umeå , Sweden.
authors.forename: Karl A
authors.initials: KA
authors.lastname: Franklin
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D004554:Electric Countershock / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000473:pathology / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000150:complications
keywords: Atrial fibrillation; cardioversion; polysomnography; sleep apnea