@article {882, title = {Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study.}, journal = {Am J Respir Crit Care Med}, volume = {173}, year = {2006}, month = {2006 Apr 15}, pages = {910-6}, abstract = {

RATIONALE: Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development.

OBJECTIVE: We postulate that the prevalence of nocturnal cardiac arrhythmias is higher among subjects with than without sleep-disordered breathing.

METHODS: The prevalence of arrhythmias was compared in two samples of participants from the Sleep Heart Health Study frequency-matched on age, sex, race/ethnicity, and body mass index: (1) 228 subjects with sleep-disordered breathing (respiratory disturbance index>or=30) and (2) 338 subjects without sleep-disordered breathing (respiratory disturbance index<5).

RESULTS: Atrial fibrillation, nonsustained ventricular tachycardia, and complex ventricular ectopy (nonsustained ventricular tachycardia or bigeminy or trigeminy or quadrigeminy) were more common in subjects with sleep-disordered breathing compared with those without sleep-disordered breathing: 4.8 versus 0.9\% (p=0.003) for atrial fibrillation; 5.3 versus 1.2\% (p=0.004) for nonsustained ventricular tachycardia; 25.0 versus 14.5\% (p=0.002) for complex ventricular ectopy. Compared with those without sleep-disordered breathing and adjusting for age, sex, body mass index, and prevalent coronary heart disease, individuals with sleep-disordered breathing had four times the odds of atrial fibrillation (odds ratio [OR], 4.02; 95\% confidence interval [CI], 1.03-15.74), three times the odds of nonsustained ventricular tachycardia (OR, 3.40; 95\% CI, 1.03-11.20), and almost twice the odds of complex ventricular ectopy (OR, 1.74; 95\% CI, 1.11-2.74). A significant relation was also observed between sleep-disordered breathing and ventricular ectopic beats/h (p<0.0003) considered as a continuous outcome.

CONCLUSIONS: Individuals with severe sleep-disordered breathing have two- to fourfold higher odds of complex arrhythmias than those without sleep-disordered breathing even after adjustment for potential confounders.

}, keywords = {Aged, Aged, 80 and over, Arrhythmias, Cardiac, Circadian Rhythm, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Odds Ratio, Polysomnography, Prevalence, Retrospective Studies, Risk Factors, Severity of Illness Index, Sleep, Sleep Apnea, Obstructive}, issn = {1073-449X}, doi = {10.1164/rccm.200509-1442OC}, author = {Mehra, Reena and Benjamin, Emelia J and Shahar, Eyal and Gottlieb, Daniel J and Nawabit, Rawan and Kirchner, H Lester and Sahadevan, Jayakumar and Redline, Susan} }