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Chest. 2019 Feb 27. pii: S0012-3692(19)30196-5. doi: 10.1016/j.chest.2019.01.033. [Epub ahead of print]

Association of short sleep duration and atrial fibrillation.

Author information

1
Division of Cardiology, Vascular Medicine Institute, University of Pittsburgh; Center for Sleep and Cardiovascular Outcomes Research, Department of Medicine, University of Pittsburgh. Electronic address: genuardimv@upmc.edu.
2
Center for Sleep and Cardiovascular Outcomes Research, Department of Medicine, University of Pittsburgh; Department of Psychiatry, University of Pittsburgh.
3
Center for Sleep and Cardiovascular Outcomes Research, Department of Medicine, University of Pittsburgh; Division of Pulmonary, Allergy, and Critical Care Medicine, Vascular Medicine Institute, University of Pittsburgh.
4
Center for Sleep and Cardiovascular Outcomes Research, Department of Medicine, University of Pittsburgh.
5
Division of Cardiology, Vascular Medicine Institute, University of Pittsburgh; Center for Sleep and Cardiovascular Outcomes Research, Department of Medicine, University of Pittsburgh.

Abstract

BACKGROUND:

Short sleep may be a risk factor for atrial fibrillation. However, previous investigations have been limited by lack of objective sleep measurement and small sample size. We sought to determine the association between objectively measured sleep duration and atrial fibrillation.

METHODS:

All 31,079 adult patients undergoing diagnostic polysomnography from 1999-2015 at multiple sites within a large hospital network were identified from electronic medical records. Prevalent atrial fibrillation was identified by continuous electrocardiography during polysomnography. Incident atrial fibrillation was identified by diagnostic codes and 12-lead electrocardiograms. Logistic regression and Cox proportional hazards modeling were used to examine the association of sleep duration and atrial fibrillation prevalence and incidence, respectively, adjusting for age, sex, body mass index, hypertension, coronary artery disease, cerebrovascular disease, peripheral vascular disease, heart failure and sleep apnea severity.

RESULTS:

We identified 404 cases of prevalent atrial fibrillation among 30,061 individuals (mean [SD] age 51.0 [14.5] years; 51.6% women) undergoing polysomnography. After adjustment, each 1-hour reduction in sleep duration was associated with a 1.17-fold (95% CI, 1.11-1.30) increased risk of prevalent atrial fibrillation. Among 27,589 patients without atrial fibrillation at baseline, we identified 1,820 cases of incident atrial fibrillation over 4.6 years median follow-up. After adjustment, each 1-hour reduction in sleep duration was associated with a 1.09-fold (95% CI, 1.05-1.13) increased risk for incident atrial fibrillation.

CONCLUSIONS:

Short sleep duration is independently associated with prevalent and incident atrial fibrillation. Further research is needed to determine whether interventions to extend sleep can lower atrial fibrillation risk.

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