The purpose of this study is to investigate the incidence of obstructive sleep apnea syndrome (OSAS) in patients with lone atrial fibrillation (AF). In addition the incidence of possible OSAS in the same group will be also evaluated.
All patients with lone AF were identified from a cardiology practice at a University Hospital. Lone AF was defined as AF in subjects less than 60 years of age and no identifiable cardiac anomaly. The subjects were then asked a set of questions. The questions were scored from 1 to 3. The questions addressed the following: Epworth sleepiness scale (ESS). ESS>10 (score 1), ESS>18 (score 2), snoring (score 1), witnessed apneas during sleep(score 3), falling asleep in inappropriate situations (score 2), unrefreshed sleep (score 1), and history of OSAS diagnosed by nocturnal polysomnography (NPSG). The subjects were then classified into five classes. Class I highly unlikely to have OSAS (score <1), class II unlikely to have OSAS (score 2), class III likely to have OSAS (score 3), class IV highly likely to have OSAS (score >3), and class V definite OSAS (OSAS diagnosed by NPSG). An age, sex and weight matched control group was evaluated. Subjects with history of cardiac dysrythmias or palpitations were excluded from the control group.
A total of 18 subjects with lone AF were identified. The control group included 50 subjects. The results are summarized in the following table.
Age (years)BMI (kg/m2)Male (%)Female (%)OSAS (%)Class III/IV (%)AF(n=18)42.3+726+2.472282711.1Control(n=50)40+627+4.9643604P valueNSNSNSNS0.0090.001
There is an increased incidence of OSAS as well as possible OSAS in patients with lone AF compared to control. 27% of patients with lone AF had OSAS compared to 0% in the control group (p=0.009). In addition 11.1% in the lone AF group were likely or highly likely to have OSAS (Class III or IV)compared to 4% in the control group (p=0.001).
Patients with lone AF should be investigated for the possibility of OSAS. Those found to have possible OSAS should be referred for NPSG and appropriate therapy recommended.
M. Chalhoub, None.