Obstructive sleep apnea and atrial fibrillation: insights from a bidirectional Mendelian randomization study

Area of Science:

• Cardiology
• Genetics
• Sleep Medicine

Background:

• Observational studies suggest a link between obstructive sleep apnea (OSA) and atrial fibrillation (AF).
• Previous studies may be confounded, leaving the causal nature of the OSA-AF relationship unclear.

Purpose of the Study:

• To clarify the causal inference between obstructive sleep apnea (OSA) and atrial fibrillation (AF).
• To investigate the relationship using a bidirectional Mendelian randomization (MR) approach.

Main Methods:

• Utilized genetic instruments for OSA and AF from genome-wide association studies.
• Employed the fixed-effects inverse-variance weighted (IVW) method as the primary analysis.
• Conducted sensitivity analyses, replication analyses, and multivariable MR to confirm findings and adjust for confounders.

Main Results:

• Genetic liability to OSA was significantly associated with an increased risk of AF (OR 1.210, P=1.51×10⁻⁶).
• Findings were consistent across sensitivity, replication, and multivariable MR analyses.
• Reverse MR analyses indicated no causal effect of AF on OSA.

Conclusions:

• This study provides strong causal evidence linking genetically predicted OSA to a higher risk of AF.
• Early screening and effective management of OSA may offer anti-arrhythmic benefits, potentially reducing AF incidence.