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Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study.

TitleAssociation of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study.
Publication TypeJournal Article
Year of Publication2006
AuthorsMehra, R, Benjamin, EJ, Shahar, E, Gottlieb, DJ, Nawabit, R, H Kirchner, L, Sahadevan, J, Redline, S
Corporate/Institutional AuthorsSleep Heart Health Study,
JournalAm J Respir Crit Care Med
Volume173
Issue8
Pagination910-6
Date Published2006 Apr 15
ISSN1073-449X
KeywordsAged, 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
Abstract<p><b>RATIONALE: </b>Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development.</p><p><b>OBJECTIVE: </b>We postulate that the prevalence of nocturnal cardiac arrhythmias is higher among subjects with than without sleep-disordered breathing.</p><p><b>METHODS: </b>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).</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p>
DOI10.1164/rccm.200509-1442OC
Alternate JournalAm J Respir Crit Care Med
PubMed ID16424443
PubMed Central IDPMC2662909
Grant ListU01HL53937 / HL / NHLBI NIH HHS / United States
U01HL64360 / HL / NHLBI NIH HHS / United States
U01HL53938 / HL / NHLBI NIH HHS / United States
U01HL53934 / HL / NHLBI NIH HHS / United States
U01HL53931 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
U01HL53916 / HL / NHLBI NIH HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States
U01HL63463 / HL / NHLBI NIH HHS / United States