Polysomnographic sleep architectural disruption associated with atrial fibrillation development
Catherine M Heinzinger1, Nicolas R Thompson2,3, Alex Milinovich2
1Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Sleep
|March 4, 2025
Summary
Reduced sleep time and increased sleep disruption are linked to a higher incidence of atrial fibrillation (AF). These findings suggest sleep quality may be a factor in AF development, warranting further investigation for prevention strategies.
Area of Science:
- Sleep Medicine
- Cardiology
- Epidemiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia with multifactorial causes.
- The specific role of sleep architectural disruption in AF development remains unclear and inconsistent.
- Understanding sleep's impact on AF is crucial for developing novel prevention strategies.
Purpose of the Study:
- To investigate the association between sleep architectural disruption and the incidence of atrial fibrillation (AF).
- To clarify the role of specific sleep parameters, such as total sleep time and sleep efficiency, in AF development.
- To determine if sleep macro-architecture is a modifiable risk factor for AF.
Main Methods:
- A large cohort of 27,232 adult patients undergoing in-laboratory sleep studies between 2000-2015 was analyzed.
- Primary predictors included arousal index and total sleep time; secondary predictors encompassed sleep efficiency, wakefulness after sleep onset, and sleep stage percentages.
- Cox proportional hazard models were used to predict AF incidence, adjusting for numerous demographic, clinical, and medication-related covariates.
Main Results:
- In a cohort of 27,232 individuals, 7.6% developed incident AF over a mean follow-up of 7.8 years.
- Decreased total sleep time, reduced sleep efficiency, and increased wakefulness after sleep onset were significantly associated with higher AF incidence.
- Higher percentage of N1 sleep stage was also linked to increased AF risk, while arousal index showed no association.
Conclusions:
- Reduced sleep duration and increased sleep fragmentation are associated with a higher risk of developing atrial fibrillation.
- These findings highlight the potential influence of sleep macro-architecture on AF development.
- Further mechanistic and prospective studies are warranted to confirm sleep disruption as a target for AF prevention.
Related Concept Videos
01:24Sleep-Wake Cycles
1.2K
Sleep is an essential physiological process vital to maintaining overall well-being. The reticular activating system (RAS), a network of neurons in the brainstem, regulates wakefulness and sleep. While it may seem passive, sleep consists of distinct cycles, each with its unique characteristics and functions. Two key sleep phases are non-rapid eye movement (NREM) and rapid eye movement (REM).
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
1.2K
01:28Disturbances in Heart Rhythm
919
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
919
01:15REM Sleep Behavior Disorder
162
REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
RBD is significantly associated with...
162
01:07Narcolepsy
95
Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
95
01:17Sleepwalking and Sleep Talking
131
Somnambulism, commonly known as sleepwalking, involves individuals engaging in activities ranging from simple walking to more complex behaviors such as driving. Sleepwalking typically occurs during the slow-wave sleep stages 3 and 4 early in the night when the person is not dreaming, contradicting the myth that sleepwalkers are acting out their dreams.
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
131
01:27Insomnia
81
Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Multiple factors contribute...
81