Chest
Original ResearchSleep DisordersSleep-Disordered Breathing and Excessive Daytime Sleepiness in Patients With Atrial Fibrillation
Section snippets
Subjects
From June 2004 to April 2009 we conducted a prospective study of patients referred to the Mayo Clinic Center for Sleep Medicine for a sleep evaluation following DCCV treatment of AF. A total of 151 patients who underwent in-laboratory-attended polysomnography were included in the analysis. Echocardiography generally was performed prior to DCCV. This study was approved by the Mayo Clinic Institutional Review Board (IRB-#1646).
Daytime Sleepiness
To assess the degree of daytime sleepiness, all patients completed the
Results
Demographic characteristics of all subjects according to the presence or absence of EDS are reported in Table 1. Mean age was 69.1 ± 0.9 years, mean BMI was 34.1 ± 0.7 kg/m2, and 76% of the patients were men. The mean left ventricular ejection fraction was 55.3% ± 1.1%; only 14% of the subjects had a left ventricular ejection fraction of ≤ 40%. The overall prevalence of SDB was 81.4%. OSA, as defined by an AHI of ≥ 5 events/h, was present in 57% of the subjects; using an AHI cutoff of ≥ 15
Discussion
The present study demonstrates that SDB is highly prevalent in patients with AF referred for sleep evaluation following DCCV who, despite marked elevations in the AHI, generally do not report subjective daytime sleepiness. Furthermore, EDS does not correlate with the presence or absence of SDB. Given the very high prevalence of SDB in patients with AF, the lack of sleepiness cannot be used to rule out the presence of SDB.
The data suggest that typical symptoms such as EDS cannot be relied on as
Acknowledgments
Author contributions: Drs Albuquerque, Calvin, Sert Kuniyoshi, Somers, and Caples had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Albuquerque: contributed to the study concept and design; data acquisition, interpretation, and analysis; drafting of the manuscript; and critical revision of the manuscript.
Dr Calvin: contributed to the study concept and design; data acquisition, interpretation, and
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Funding/Support: This work was supported by the Mayo Clinic Clinician-Investigator Training Program; Mayo Foundation; American Heart Association [Grant 04-50103Z]; National Heart, Lung, and Blood Institute [Grants HL65176, HL70302, HL73211, and HL099534]; the National Center for Research Resources (NCRR) [Grant 1ULI RR024150], a component of the National Institutes of Health (NIH); IGA of Ministry of Health No. NS10098-4/2008; European Regional Development Fund-Project FNUSA-ICRC [No. CZ.1.05/1.1.00/02.0123]; and the NIH Roadmap for Medical Research.
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