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Updated: Jan 28, 2026
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Published on: December 6, 2016
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Obstructive sleep apnea and electrocardiographic P-wave morphology
Paul S Corotto1, Hyojung Kang2, Brianna Massaro3
1Lehigh Valley Heart Institute, LVPG Cardiology, Allentown, Pennsylvania.
Summary
Obstructive sleep apnea (OSA) severity is linked to abnormal electrocardiogram (ECG) P-wave morphology, indicating left atrial abnormality. This finding highlights cardiovascular risks associated with OSA, including atrial fibrillation and stroke.
Area of Science:
- Cardiology
- Sleep Medicine
- Medical Diagnostics
Background:
- Obstructive sleep apnea (OSA) is a common sleep disorder with significant cardiovascular consequences.
- Left atrial abnormality, detectable via electrocardiogram (ECG) P-wave morphology, is a risk factor for atrial fibrillation (AF) and stroke.
- Previous research suggests an association between OSA and these cardiovascular events.
Purpose of the Study:
- To investigate the association between the severity of obstructive sleep apnea (OSA) and electrocardiogram (ECG)-defined left atrial abnormality.
- To determine if P-wave terminal force in V1 (PTFV1) and P-wave area in V1 (PWAV1) correlate with OSA severity.
Main Methods:
- Retrospective review of 261 patients who underwent polysomnography and ECG.
- Logistic regression analysis to assess the relationship between OSA severity (apnea-hypopnea index [AHI] and mean nocturnal oxygen saturation) and abnormal PTFV1/PWAV1.
- Adjustments were made for age, sex, body mass index, and hypertension.
Main Results:
- Increased apnea-hypopnea index (AHI) was significantly associated with abnormal PTFV1 and PWAV1.
- Lower mean nocturnal oxygen saturation was linked to abnormal PWAV1.
- These associations remained significant after excluding patients on AV nodal blocking agents.
Conclusions:
- A significant association exists between obstructive sleep apnea severity and ECG-defined left atrial abnormality in a sleep clinic population.
- These findings underscore the importance of evaluating cardiovascular risks in patients with OSA.
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