Does OSA Increase Atrial Fibrillation Risk?

Obstructive sleep apnea (OSA) was associated with an increased risk for the development of atrial fibrillation (AF) within 10 years, according to the findings of a recent study.

The study included 8256 participants who underwent a first diagnostic sleep study at an academic hospital in Toronto between 1994 and 2010 (mean age 47 years, 65% of participants were men). Researchers linked data from participants to health administrative data from 1991 to 2015, and assessed incident hospitalization with AF as the primary outcome.
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A total of 173 (2.1%) participants were hospitalized with AF over the median 10 years of follow-up. Participants who were hospitalized with AF were more likely to be older, men, current or former smokers, had higher levels of comorbidities, and more severe OSA determined by the apnea-hypopnea index (AHI) or degree of nocturnal oxygen desaturation.

“In univariate analyses, AHI > 30 vs. AHI ≤30 events/hour and ≥ 10 vs. <10 min of sleep time spent with oxygen desaturation <90% were significant predictors of hospitalized AF: [hazard ratio (HR)] = 1.92, 95% CI: 1.41-2.62 and HR = 2.81, 95% CI: 2.07-3.81, respectively,” the researchers wrote.

Sleep time spent with oxygen desaturation below 90% remained significantly associated with hospitalization for AF after researchers controlled for known risk factors such as age, sex, smoking status, alcohol dependency, prior congestive heart failure, chronic obstructive pulmonary disease, and pulmonary embolism/infarction (HR 1.64). The association was significantly stronger for women compared with men.

“In a large clinical cohort with suspected OSA free of any arrhythmias at baseline, sleep time spent with oxygen desaturation<90% was a significant independent predictor of incident hospitalization for AF over the next ten years,” the researchers concluded. “These findings support a causal relationship between OSA, chronic nocturnal hypoxemia and new onset atrial fibrillation.”

—Melissa Weiss

Reference:

Kendzerska T, Gershon AS, Atzema C, Hawker G, and Leung R. Sleep apnea increases the risk of new onset atrial fibrillation: a clinical cohort study. Presented at: American Thoracic Society 2017 International Conference; May 19-24, 2017; Washington, DC. Abstract 3913.