Predominant obstructive or central sleep apnea in patients with atrial fibrillation: influence of characterizing apneas versus apneas and hypopneas |
| |
| Affiliation: | 1. Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium;2. Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium;3. Université Catholique de Louvain, Department of Anaesthesiology, Cliniques universitaires Saint-Luc, Brussels, Belgium;1. Royal Blackburn Hospital, Blackburn, UK;2. Wythenshawe Hospital, Manchester, UK;3. Department of Primary Healthcare Sciences, University of Oxford, UK;1. Department of Mechanical Engineering Science, Faculty of Engineering and the Built Environment, University of Johannesburg, South Africa;2. Department of Mechanical and Industrial Engineering Technology, Faculty of Engineering and the Built Environment, University of Johannesburg, South Africa;2. Anesthesia and Critical Care Medicine, Johns Hopkins University, Baltimore, MD;3. Psychiatry & Behavioral Science—Stanford Center for Sleep Sciences and Medicine, Stanford University School of Medicine, Stanford, CA;4. Health Research and Policy, Stanford University, Stanford, CA;5. Department of Anesthesia; Veterans Affairs Medical Center, West Los Angeles, Los Angeles, CA;6. Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA |
| |
| Abstract: | Objective/backgroundSleep-disordered breathing (SDB) is common in patients with atrial fibrillation (Afib). Although a high proportion of respiratory events are hypopneas, previous studies have only used apneas to differentiate obstructive (OSA) from central (CSA) sleep apnea. This study investigated the impact of using apneas and hypopneas versus apneas only to define the predominant type of SDB in Afib patients with preserved ejection fraction.Patients/methodsThis retrospective analysis was based on high-quality cardiorespiratory polygraphy (PG) recordings (07/2007–03/2016) that were re-analyzed using 2012 American Academy of Sleep Medicine criteria, with differentiation of apneas and hypopneas as obstructive or central. Classification of predominant (>50% of events) OSA and CSA was defined based on apneas only (OSAAI and CSAAI) or apneas and hypopneas (OSAAHI and CSAAHI). SDB was defined as an apnea–hypopnea index ≥5/h.ResultsA total of 211 patients were included (146 male, age 68.7 ± 8.5 y). Hypopneas accounted for >50% of all respiratory events. Based on apneas only, 46% of patients had predominant OSA and 44% had predominant CSA. Based on apneas and hypopneas, the proportion of patients with OSA was higher (56%) and that with CSA was lower (36%). In the subgroup of patients with moderate to severe SDB (AHI ≥ 15/h), the proportion with predominant CSA was 55.2% based on apneas only versus 42.1% with apneas and hypopneas.ConclusionsIn hospitalized patients with Afib and SDB, use of apneas and hypopneas versus apneas alone had an important influence on the proportion of patients classified as having predominant OSA or CSA. |
| |
| Keywords: | Atrial fibrillation Sleep-disordered breathing Obstructive sleep apnea Central sleep apnea Hypopnea |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
