Previously Undetected Obstructive Sleep Apnea in Patients With New-Onset Atrial Fibrillation.

Area of Science:

• Cardiology
• Sleep Medicine
• Pulmonology

Background:

• Obstructive sleep apnea (OSA) significantly impacts atrial fibrillation (AF) management.
• Continuous positive airway pressure (CPAP) may improve AF control, particularly in early stages.

Purpose of the Study:

• To evaluate a practical screening strategy for identifying new-onset AF patients likely to benefit from CPAP.
• To determine the predictive value of questionnaires versus conventional risk factors for CPAP indication.

Main Methods:

• Prospective evaluation of 73 new-onset AF patients using Epworth, Berlin, and STOP-BANG questionnaires.
• Ambulatory polysomnography to determine apnea-hypopnea index (AHI).
• Descriptive, univariate, and multivariate analyses to identify predictors of OSA and CPAP need.

Main Results:

• OSA prevalence was 82%, with 37% requiring CPAP.
• Male gender, BMI, obesity, hypertension, and high scores on Berlin/STOP-BANG questionnaires correlated with higher AHI.
• STOP-BANG score (≥4) was the sole predictor of CPAP indication (OR 4.5, p=0.01), with 76% sensitivity and 65% specificity.

Conclusions:

• New-onset AF patients exhibit a high prevalence of OSA and a significant need for CPAP.
• A STOP-BANG score of ≥4 serves as a practical and effective screening tool for CPAP indication in this population, potentially reducing the need for immediate polysomnography.