Implication of Apnea‐Hypopnea Index, a Measure of Obstructive Sleep Apnea Severity, for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy

Background: Obstructive sleep apnea (OSA) is a modifiable risk factor of atrial fibrillation (AF) but is underdiagnosed in these patients due to absence of good OSA screening pathways. Polysomnography (PSG) is the gold standard for diagnosing OSA but too resource-intensive as a screening tool. We explored whether cardiorespiratory polygraphy (PG) devices using an automated algorithm for Apnea-Hypopnea Index (AHI) determination can meet the requirements of a good screening tool in AF patients.Methods: This prospective study validated the performance of three PGs [ApneaLink Air (ALA), SOMNOtouch RESP (STR) and SpiderSAS (SpS)] in consecutive AF patients who were referred for PSG evaluation. Patients wore one of the three PGs simultaneously with PSG, and a different PG during each of three consecutive nights at home. Severity of OSA was classified according to the AHI during PSG (<5 = no OSA, 5–14 = mild, 15–30 = moderate, >30 = severe).Results: Of the 100 included AF patients, PSG diagnosed at least moderate in 69% and severe OSA in 33%. Successful PG execution at home was obtained in 79.1, 80.2 and 86.8% of patients with the ALA, STR and SpS, respectively. For the detection of clinically relevant OSA (AHI ≥ 15), an area under the curve of 0.802, 0.772 and 0.803 was calculated for the ALA, STR and SpS, respectively.Conclusions: This study indicates that home-worn PGs with an automated AHI algorithm can be used as OSA screening tools in AF patients. Based on an appropriate AHI cut-off value for each PG, the device can guide referral for definite PSG diagnosis.

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Apnea-hypopnea index versus oxygen desaturation index for diagnosis of obstructive sleep apnea in patients with atrial fibrillation: six of one, half a dozen of the other?

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.9524 ◽

2021 ◽

Author(s):

Chou-Han Lin ◽

Chih-Chieh Yu

Keyword(s):

Atrial Fibrillation ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Oxygen Desaturation ◽

The Other ◽

Apnea Hypopnea Index ◽

Desaturation Index ◽

Oxygen Desaturation Index ◽

Obstructive Sleep

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Atrial Fibrillation Is Associated With Increased Mean Platelet Volume and Apnea Hypopnea Index in Patients With Obstructive Sleep Apnea

Angiology ◽

10.1177/0003319714548567 ◽

2014 ◽

Vol 66 (6) ◽

pp. 525-530 ◽

Cited By ~ 9

Author(s):

Aydın Akyüz ◽

Dursun Çayan Akkoyun ◽

Hasan Değirmenci ◽

Recep Alp

Keyword(s):

Atrial Fibrillation ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Mean Platelet Volume ◽

Apnea Hypopnea Index ◽

Platelet Volume ◽

Obstructive Sleep

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Prevalence and analysis of respiratory and anthropometric parameters in patients with obstructive sleep apnea

Research Society and Development ◽

10.33448/rsd-v10i3.13455 ◽

2021 ◽

Vol 10 (3) ◽

pp. e32410313455

Author(s):

Danilo Sobral da Silva Fernandes ◽

Manoel Pereira Guimarães ◽

Einstein Zeus Alves de Brito ◽

João Diego Cabral Lima ◽

Mateus de Sousa Rodrigues ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Lung Function ◽

Pulmonary Function ◽

Forced Expiratory Volume ◽

Apnea Hypopnea Index ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Obstructive Sleep Apnea Severity ◽

Obstructive Sleep

Introduction: Obstructive sleep apnea is a condition characterized by frequent respiratory pauses lasting ≥ 10 seconds, accompanied by desaturation/reoxygenation cycles and repetitive arousals triggered by complete (apnea) or partial (hypopnea) cessation of airflow during sleep. Objective: To determine the prevalence and to assess the respiratory and anthropometric parameters of patients with obstructive sleep apnea in Vale do São Francisco area. Methods: This is a descriptive, cross-sectional study using secondary data collected from 466 patients between June 2015 and June 2017. Patients who underwent home polysomnography were included while those who did not perform the lung function test and/or failed to present a medical report were excluded. Results: Obstructive sleep apnea was observed in 79.2% (n = 126) of the patients enrolled. Cases with greater severity were observed in males and were more prevalent among those aged 60 years or above. Forced expiratory volume in 1 second (P = 0.006) and forced vital capacity (P = 0.001) decreased with increased obstructive sleep apnea severity. Significant correlations were observed between the severity of obstructive sleep apnea and age, body mass index and Apnea-Hypopnea Index, while pulmonary function variables presented a low negative correlation with obstructive sleep apnea severity. Conclusion: Greater severity of obstructive sleep apnea was more prevalent in males and the involvement of the pulmonary function was more pronounced in the groups with severe obstructive sleep apnea. Reductions in lung function were also found in this population, with negative linear correlations between ventilatory parameters and obstructive sleep apnea severity.

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Obstructive Sleep Apnea Is Common and Independently Associated With Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy

CHEST Journal ◽

10.1378/chest.09-2335 ◽

2010 ◽

Vol 137 (5) ◽

pp. 1078-1084 ◽

Cited By ~ 49

Author(s):

Rodrigo P. Pedrosa ◽

Luciano F. Drager ◽

Pedro R. Genta ◽

Aline C.S. Amaro ◽

Murillo O. Antunes ◽

...

Keyword(s):

Atrial Fibrillation ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Hypertrophic Cardiomyopathy ◽

Obstructive Sleep

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COEXISTENT HYPERTROPHIC CARDIOMYOPATHY AND OBSTRUCTIVE SLEEP APNEA INCREASE THE RISK OF ARRHYTHMIA RECURRENCE FOLLOWING CATHETER ABLATION OF ATRIAL FIBRILLATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)30853-1 ◽

2016 ◽

Vol 67 (13) ◽

pp. 852

Author(s):

Sanghamitra Mohanty ◽

Prasant Mohanty ◽

Chintan Trivedi ◽

Carola Gianni ◽

Amin Al-Ahmad ◽

...

Keyword(s):

Atrial Fibrillation ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Hypertrophic Cardiomyopathy ◽

Catheter Ablation ◽

Obstructive Sleep

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Obstructive Sleep Apnea, Other Sleep Characteristics, and Risk of CKD in the Atherosclerosis Risk in Communities Sleep Heart Health Study

Journal of the American Society of Nephrology ◽

10.1681/asn.2020010024 ◽

2020 ◽

Vol 31 (8) ◽

pp. 1859-1869 ◽

Cited By ~ 1

Author(s):

Kelsie M. Full ◽

Chandra L. Jackson ◽

Casey M. Rebholz ◽

Kunihiro Matsushita ◽

Pamela L. Lutsey

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Apnea Hypopnea Index ◽

Lifestyle Behaviors ◽

Atherosclerosis Risk In Communities ◽

Obstructive Sleep Apnea Severity ◽

Obstructive Sleep ◽

Increased Risk ◽

Ckd Stage ◽

Atherosclerosis Risk

BackgroundObstructive sleep apnea may be associated with development of CKD through hypoxia, inflammation, and oxidative stress. Individuals with this sleep disorder are also at increased risk for established CKD risk factors, including obesity, hypertension, and type 2 diabetes.MethodsWe examined the association between obstructive sleep apnea, other sleep characteristics, and risk of incident CKD (stage 3 or higher) in 1525 participants (mean age, 62.5 years; 52.4% women) in the Atherosclerosis Risk in Communities (ARIC) study who completed in-home polysomnography assessments. We used the apnea-hypopnea index (events per hour) to define obstructive sleep apnea severity (normal, <5.0; mild, 5.0–14.9; moderate, 15.0–29.9; and severe, ≥30.0) and defined incident CKD (stage 3 or higher) as eGFR<60 ml/min per 1.73 m2 and ≥25% decline from baseline, CKD-related hospitalization or death, or ESKD. Cox proportional hazards regression was used to estimate obstructive sleep apnea severity with risk of incident CKD, adjusting for demographics, lifestyle behaviors, and cardiometabolic conditions.ResultsDuring 19 years (median) of follow-up, 461 CKD events occurred. After adjustment for demographics and lifestyle behaviors, severe obstructive sleep apnea associated with increased risk of CKD (hazard ratio [HR], 1.51; 95% confidence interval [95% CI], 1.08 to 2.10), which was attenuated after adjustment for body mass index (HR, 1.07; 95% CI, 0.75 to 1.52). No other sleep characteristics associated with incident CKD.ConclusionsWe found a link between obstructive sleep apnea and an elevated risk of stage 3 CKD or higher, but this association was no longer significant after adjusting for obesity, a risk factor for both conditions. Given the high prevalence of obstructive sleep apnea and CKD among adults, further investigation is warranted.

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The prevalence of sleep breathing disorders in patients with atrial fibrillation undergoing catheter treatment

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-1-36-42 ◽

2019 ◽

Vol 15 (1) ◽

pp. 36-42

Author(s):

M. V. Agaltsov ◽

O. M. Drapkina ◽

K. V. Davtyan ◽

G. G. Arutyunyan

Keyword(s):

Atrial Fibrillation ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Apnea Hypopnea Index ◽

Moderate Degree ◽

Sleep Monitoring ◽

Mild Degree ◽

Sleep Breathing Disorders ◽

Breathing Disorders ◽

Obstructive Sleep

Aim. To study the prevalence of obstructive sleep apnea (OSA) among patients with atrial fibrillation (AF) who have undergone catheter treatment for this arrhythmia, as well as to study the possible interrelationships of these sleep breathing disorders with comorbid diseases and the received therapy in this cohort.Material and methods. 231 patients from a random sample were examined (men – 118 [51.1%], mean age 57.8±9.3 years) in the range of 1-6 months after catheter therapy for AF. All patients underwent cardiorespiratory sleep monitoring for one night. The criterion for OSA severity was apnea/hypopnea index (AHI) for hour (the norm is less than 5 events/h). Depending on the results obtained, all patients were divided into groups without apnea and with apnea of varying severity – a mild degree with an AHI value of 5 to 15 events/h, moderate severity with an AHI value of 16 to 30 events/h, and severe degree when the value of AHI more than 30 events/h. The study was performed without abolishing the basic therapy.Results. According to the results of cardiorespiratory sleep monitoring 127 patients (56.7%) with OSA criteria, were registered. Among them, a mild degree of OSA was found in 35.4% (n=45), a moderate degree – in 40.9% (n=52), and severe one – in 23.7% (n=30) of all patients with apnea. Among patients with obstructive sleep apnea 51.1% were males. Arterial hypertension was significantly more frequent in patients with OSA of pronounced degrees of severity compared with patients without apnea (p=0.047). Weight and body mass index of patients with OSA were significantly higher than in patients without apnea (p=0.001 and p=0.001, respectively). The left atrium (LA) size in patients with severe OSA was significantly larger than in patients without apnea (p=0.0005), which may indicate a possible contribution of severe obstructive apnea to the arrhythmia generating. OSA was the strongest independent factor among others related to the LA size (odds ratio was 1.6; 95% confidence interval 1.2-2.1; p<0.0003).Conclusion. Obstructive sleep apnea is very widespread among a cohort of patients with AF who have undergone a catheter procedure to isolate the pulmonary veins. Sleep breathing disorder is the strongest and most independent risk factor for AF associated with increased LA, among other risk factors such as age, hypertension, and obesity.

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