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Linz D, Baumert M, Desteghe L, et al. Nightly sleep apnea severity in patients with atrial fibrillation: Potential applications of long-term sleep apnea monitoring. Int J Cardiol Heart Vasc. 2019;24:100424doi: 10.1016/j.ijcha.2019.100424.
Linz, D., Baumert, M., Desteghe, L., Kadhim, K., Vernooy, K., Kalman, J. M., Dobrev, D., Arzt, M., Sastry, M., Crijns, H. J. G. M., Schotten, U., Cowie, M. R., McEvoy, R. D., Heidbuchel, H., Hendriks, J., Sanders, P., & Lau, D. H. (2019). Nightly sleep apnea severity in patients with atrial fibrillation: Potential applications of long-term sleep apnea monitoring. International journal of cardiology. Heart & vasculature, 24100424. https://doi.org/10.1016/j.ijcha.2019.100424
Linz, Dominik, et al. "Nightly sleep apnea severity in patients with atrial fibrillation: Potential applications of long-term sleep apnea monitoring." International journal of cardiology. Heart & vasculature vol. 24 (2019): 100424. doi: https://doi.org/10.1016/j.ijcha.2019.100424
Linz D, Baumert M, Desteghe L, Kadhim K, Vernooy K, Kalman JM, Dobrev D, Arzt M, Sastry M, Crijns HJGM, Schotten U, Cowie MR, McEvoy RD, Heidbuchel H, Hendriks J, Sanders P, Lau DH. Nightly sleep apnea severity in patients with atrial fibrillation: Potential applications of long-term sleep apnea monitoring. Int J Cardiol Heart Vasc. 2019 Oct 18;24:100424. doi: 10.1016/j.ijcha.2019.100424. eCollection 2019 Sep. PMID: 31763438; PMCID: PMC6859526.
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Int J Cardiol Heart Vasc. 2019 Oct 18;24:100424. doi: 10.1016/j.ijcha.2019.100424. eCollection 2019 Sep.

Nightly sleep apnea severity in patients with atrial fibrillation: Potential applications of long-term sleep apnea monitoring.

International journal of cardiology. Heart & vasculature

Dominik Linz, Mathias Baumert, Lien Desteghe, Kadhim Kadhim, Kevin Vernooy, Jonathan M Kalman, Dobromir Dobrev, Michael Arzt, Manu Sastry, Harry J G M Crijns, Ulrich Schotten, Martin R Cowie, R Doug McEvoy, Hein Heidbuchel, Jeroen Hendriks, Prashanthan Sanders, Dennis H Lau

Affiliations

  1. Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
  2. Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands.
  3. Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands.
  4. University Maastricht, Cardiovascular Research Institute Maastricht (CARIM), the Netherlands.
  5. University of Adelaide, School of Electrical and Electronic Engineering, Adelaide, Australia.
  6. Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
  7. Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.
  8. Department of Cardiology, Royal Melbourne Hospital and Department of Medicine, University of Melbourne, Melbourne, Australia.
  9. Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, Essen, Germany.
  10. Department of Internal Medicine II, University Medical Centre Regensburg, Regensburg, Germany.
  11. Academic Sleep Centre (CIRO+), Horn, the Netherlands.
  12. National Heart and Lung Institute, Imperial College London (Royal Brompton Hospital), London, England, UK.
  13. Adelaide Institute for Sleep Health (AISH), College of Medicine and Public Health, Flinders University and Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, Australia.
  14. University of Antwerp and Antwerp University Hospital, Edegem, Belgium.

PMID: 31763438 PMCID: PMC6859526 DOI: 10.1016/j.ijcha.2019.100424

Abstract

In patients with atrial fibrillation (AF), the prevalence of moderate-to-severe sleep-disordered breathing (SDB) ranges between 21% and 72% and observational studies have demonstrated that SDB reduces the efficacy of rhythm control strategies, while treatment with continuous positive airway pressure lowers the rate of AF recurrence. Currently, the number of apneas and hypopneas per hour (apnea-hypopnea-index, AHI) determined during a single overnight sleep study is clinically used to assess the severity of SDB. However, recent studies suggest that SDB-severity in an individual patient is not stable over time but exhibits a considerable night-to-night variability which cannot be detected by only one overnight sleep assessment. Nightly SDB-severity assessment rather than the single-night diagnosis by one overnight sleep study may better reflect the exposure to SDB-related factors and yield a superior metric to determine SDB-severity in the management of AF. In this review we discuss mechanisms of night-to-night SDB variability, arrhythmogenic consequences of night-to-night SDB variability, strategies for longitudinal assessment of nightly SDB-severity and clinical implications for screening and management of SDB in AF patients.

© 2019 The Author(s).

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