期刊
SLEEP AND BREATHING
卷 27, 期 2, 页码 487-494出版社
SPRINGER HEIDELBERG
DOI: 10.1007/s11325-022-02625-y
关键词
Positional sleep apnea; Obstructive sleep apnea; Atrial fibrillation
This study investigated the prevalence and associated factors of positional obstructive sleep apnea (POSA) in patients with atrial fibrillation (AF). The results showed that POSA prevalence was similar between patients with and without AF. Obesity and severe OSA were associated with lower odds of POSA, while male sex was associated with higher odds of POSA in patients with AF.
Purpose Obstructive sleep apnea (OSA) is a common, potentially modifiable condition implicated in the pathogenesis of atrial fibrillation (AF). The presence and severity of OSA is largely sleep position-dependent, yet there is high variability in positional dependence among patients with OSA. We investigated the prevalence of positional OSA (POSA) and examined associated factors in patients with AF. Methods We recruited an equal number of patients with and without AF who underwent diagnostic polysomnography. Patients included had >= 120 min of total sleep time with 30 min of sleep in both supine and lateral positions. POSA was defined as an overall apnea hypopnea index (AHI) >= 5/h, supine AHI (sAHI) >= 5/h, and sAHI greater than twice the non-supine AHI. POSA prevalence was compared in patients with and without AF adjusting for age, sex, OSA severity, and heart failure. Results A total of patients (male: 56%, mean age 62 years) were included. POSA prevalence was similar between the two groups (46% vs. 39%; p = 0.33). Obesity and severe OSA (AHI >= 30/h) were associated with low likelihood of POSA (OR [CI] of 0.17 [0.09-0.32] and 0.28 [0.12-0.62]). In patients with AF, male sex was associated with a higher likelihood of POSA (OR [CI] of 3.16 [1.06-10.4]). Conclusion POSA is common, affecting more than half of patients with AF, but the prevalence was similar in those without AF. Obesity and more severe OSA are associated with lower odds of POSA. Positional therapy should be considered in patients with mild OSA and POSA.
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