I could not find this study on the Forum , so am assuming it has not yet been posted.
The latest from From Medscape Medical News
Obstructive Sleep Apnea Underestimated in Patients With Atrial Fibrillation
by Jim Kling
July 14, 2010 (San Antonio, Texas) — Obstructive sleep apnea is a frequent comorbidity in patients with atrial fibrillation, and polysomnography should be used to diagnose it. Portable diagnostic methods underestimate the incidence of obstructive sleep apnea in these patients, according to research presented here at SLEEP 2010: Associated Professional Sleep Societies 24th Annual Meeting.
Untreated obstructive sleep apnea is an important risk factor for atrial fibrillation, and it causes increased cardiovascular morbidity and mortality and depression, noted Alexander Blau, MD, from the Charité Interdisciplinary Center for Sleep Medicine in Berlin, Germany, who presented the research, which was conducted at his institution.
The researchers used portable sleep apnea monitoring and laboratory polysomnography to determine the prevalence of sleep-disordered breathing in 30 patients with atrial fibrillation. The study consisted of 17 men and 13 women (mean age, 62.8 ± 9.6 years; mean body mass index, 29.4 ± 5.0 kg/m2; left ventricular ejection fraction, 57.8% ± 5.5%). Patients had either paroxysmal (n = 12; 40%) or persistent (n = 18; 60%) atrial fibrillation.
The researchers used portable polygraphy to examine nasal flow, breathing movements, oxygen desaturation, and electrocardiogram. Sleep-disordered breathing was defined as an apnea hypopnea index (AHI) of at least 5, and upon diagnosis the researchers performed in-laboratory attended polysomnography.
Polygraphy identified sleep-disordered breathing in 17 of 30 subjects (56.7%; AHI, 9.0 ± 7.7/hour). Of these, 13 patients had mild (AHI, 5 to 15/hour) and 4 had moderate sleep-disordered breathing (AHI, 15 to 30/hour). Excessive daytime sleepiness (Epworth Sleepiness Scale >9) was found in 4 subjects. Sleep-disordered breathing was confirmed using polysomnography (AHI, 37.3 ± 9.7/hour).
Dr. Blau said that in all patients, AHI calculated using polysomnography revealed more severe sleep apnea than that using the portable monitor.
"A remarkable prevalence of sleep-disordered breathing was observed in patients with atrial fibrillation. . . . Sleep apnea severity assessed by polysomnography can determine not only OSA severity, but can also reveal other medical risk," the researchers wrote in the abstract.
"Polygraphy underestimates sleep-disordered breathing in this group of patients," Dr. Blau told Medscape Medical News. Dr. Blau was not directly involved in the research but often collaborates with the researchers, who were unable to attend the session themselves. He added that he believes that AHI should be assessed in all patients with atrial fibrillation.
"One of the strongest associations between sleep-disordered breathing and another medical condition is atrial fibrillation, and it's one of the most common heart arrhythmias," David Kuhlmann, MD, medical director of sleep medicine at the Bothwell Regional Health Center in Sedalia, Missouri, who attended the session, told Medscape Medical News.
The researchers didn't identify which portable device they used, and Dr. Kuhlmann considers this a weakness of the study. "It's a comparison between polysomnography and whatever device they used. It can't be applied to all the other devices. But it's important to think about. You don't want to miss [sleep apnea] when someone can benefit so much from treatment," Dr. Kuhlmann added.
The study did not receive commercial support. Dr. Blau and Dr. Kuhlmann have disclosed no relevant financial relationships.
SLEEP 2010: Associated Professional Sleep Societies 24th Annual Meeting: Abstract 0397. Presented June 7, 2010.
Large print by courtesy of Cpaptalk programmers.
A recent informative thread on the subject can be found at -
viewtopic.php?f=1&t=53453&p=495683&hili ... on#p495683
cheers
Mars
