Cardiac Arrhythmias and Sleep Disorders

Sleep disordered breathing (SDB), periodic limb movements of sleep, insomnia, sleep curtailment, and sleep architectural changes are associated with cardiac arrhythmias in community-based and clinical cohort studies. Findings appear to be strongest in magnitude and most consistent for SDB and atrial fibrillation (AF). The mechanisms most consistently identified in animal experimental models include autonomic nervous system fluctuations and intrathoracic pressure alterations, the latter resulting in direct mechanical effects on the thin-walled atria. Other studies point toward intermittent hypoxia. Nonrandomized interventional studies suggest that the treatment of SDB reduces AF recurrence after ablation or cardioversion.