Positional obstructive sleep apnea in patients with atrial fibrillation.
Positional obstructive sleep apnea in patients with atrial fibrillation.
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房颤患者的体位性阻塞性睡眠呼吸暂停。
DOI：
10.1007/s11325-022-02625-y
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Kwon,Younghoon
中科院分区：
文献类型：
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作者：
Stafford,PatrickL;Harmon,Evan;Patel,Paras;Walker,McCall;Akoum,Nazem;Park,Seung-Jung;Cho,Yeilim;Bilchick,Kenneth;Mehta,Nishaki;Mazimba,Sula;Cho,Yoonsik;Kwon,Younghoon
目的阻塞性睡眠呼吸暂停（OSA）是一种常见的、潜在的可改变的疾病，与心房颤动（AF）的发病机制有关。OSA的存在和严重程度在很大程度上依赖于睡眠姿势，但OSA患者的姿势依赖性差异很大。我们调查了位置性阻塞性睡眠呼吸暂停（POSA）的患病率，并研究了相关因素，在患者与AF。MethodsWe招募了相同数量的患者，并没有AF进行诊断性多导睡眠图。纳入的患者总睡眠时间≥ 120分钟，仰卧位和侧卧位睡眠时间均<30分钟。POSA定义为总体呼吸暂停低通气指数（AHI）≥ 5/h，仰卧位AHI（sAHI）≥ 5/h，且sAHI大于非仰卧位AHI的两倍。POSA的患病率进行了比较，并没有AF调整年龄，性别，OSA的严重程度，和heartfailure.ResultsA总的患者（男性：56%，平均年龄62岁）。两组的POSA患病率相似（46% vs. 39%;p= 0.33）。肥胖和重度阻塞性睡眠呼吸暂停（AHI ≥ 30/h）与POSA的可能性较低相关（OR [CI]为0.17 [0.09-0.32]和0.28 [0.12-0.62]）。在AF患者中，男性与POSA的可能性更高（OR [CI]为3.16 [1.06-10.4]）。结论POSA是常见的，影响超过一半的AF患者，但患病率在那些没有AF。肥胖和更严重的OSA与POSA的几率较低。轻度OSA和POSA患者应考虑体位治疗。
PurposeObstructive 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.MethodsWe 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.ResultsA 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]).ConclusionPOSA 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.