PURPOSE: The purpose of this study is to evaluate the prevalence of sleep apnea (SA) and the effects of oxygen (O2), continuous positive airway pressure (CPAP) and bilevel noninvasive positive pressure ventilation (NPPV) on SA in persistent or permanent atrial fibrillation (AF).
METHODS: We examined 35 patients with persistent or permanent AF with the ambulatory pulse oxymeter during sleep, and the patients with oxygen desaturation index (ODI) 4% ≥ 5/h were considered to have a SA. The pulse oxymeter, chest and abdominal wall motion, nasal air flow sensor and electorcardiographic monitoring system (TEIJIN, Morpheus C) was performed during sleep under room air (control;C), O2, CPAP and NPPV in patients with SA.
RESULTS: Seventeen patients had ODI4% ≥ 5/h (49%) and the body mass index (BMI) of them (26.1) was larger than that of patients without SA (22.1; ODI4% ≤ 5/h). Two of 17 patients with SA (12%) were female although 8 of 18 patients without SA (44%) were female. Apnea hypopnea index (AHI;/h) of 17 patients with SA improved from 22 (C) to 14 (O2), 9 (CPAP) and 8 (NPPV). Central apnea index (CAI;/h)decreased from 7.5 (C) to 3.2 (O2), 1.3 (CPAP) and 0.1 (NPPV). Mean heart rate decreased from 64 (C) to 60 (O2), 62 (CPAP) and 57 (NPPV). Urinary noradrenaline concentration decreased from 1.09 (C) to 0.93 (O2), 0.89 (CPAP) and 0.85 (NPPV). Next morning mood index improved from 1.76 (C) to 2.18 (O2), 1.94 (CPAP) and 2.24 (NPPV).
CONCLUSION: These results suggest that persistent or permanent AF have high prevalence of tha SA, and over night O2, CPAP and NPPV improve the SA, mean heart rate and sympathtic nervous activity and the NPPV was the most effective.
CLINICAL IMPLICATIONS: The prevalence of SA in persistent or permanent AF is pretty high and over night O2, CPAP and NPPV may be the useful methods to improve SA and sympathetic nervous activity in these patients.
DISCLOSURE: Hitoshi Koito, None.