Nightly sleep as a predictor of next-day arrhythmias in ambulatory adults

The frequency of cardiac ectopy, including premature atrial contractions (PACs), premature ventricular contractions (PVCs), non-sustained supraventricular tachycardia (SVT), and non-sustained ventricular tachycardia (NSVT), is clinically relevant, but modifiable risk factors remain poorly understood. Sleep quality influences the risk for atrial fibrillation, but whether sleep might predict the frequency of these even more common arrhythmias is unknown.

To investigate whether sleep duration, sleep disturbances, and self-rated sleep quality predict next-day common arrhythmias in an ambulatory population.

This was a secondary analysis of the Coffee and Real-time Atrial and Ventricular Ectopy (CRAVE) trial, a randomized, 14-day case-crossover trial of the effects of coffee in 100 healthy volunteers. The current analyses utilized data from a wrist-worn accelerometer to measure sleep duration and disturbances worn concomitantly with a continuously recording electrocardiogram. Participants self-rated sleep quality via daily surveys. Negative binomial and logistic mixed-effects models were used to assess the effect of sleep on cardiac ectopy, adjusting for day of the week and randomization assignment and accounting for repeated measurement correlations within individuals.

The frequency of cardiac ectopy was not associated with sleep duration (RR, 0.99; 95% CI, 0.95-1.03), sleep disturbances (RR, 0.99; 95% CI, 0.95-1.03), or sleep quality (RR, 0.97; 95% CI, 0.91-1.04). There were no significant associations between the same predictors and individual counts of PACs or PVCs or episodes of SVT or NSVT.

We failed to find evidence of a relationship between objectively quantified sleep and continuous assessment of common arrhythmias the following day in healthy volunteers.