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Nocturnal Arrhythmias Across a Spectrum of Obstructive and Central Sleep-Disordered Breathing in Older Men: Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study
Open accessAbstract
BACKGROUND: Rates of cardiac arrhythmias increase with age and may be associated with clinically significant morbidity. We studied the association between sleep-disordered breathing (SDB) with nocturnal atrial fibrillation or flutter (AF) and complex ventricular ectopy (CVE) in older men. METHODS: A total of 2911 participants in the Outcomes of Sleep Disorders in Older Men Study underwent unattended polysomnography. Nocturnal AF and CVE were ascertained by electrocardiogram-specific analysis of the polysomnographic data. Exposures were (1) SDB defined by respiratory disturbance index (RDI) quartile (a major index including all apneas and hypopneas), and ancillary definitions incorporating (2) obstructive events, obstructive sleep apnea (OSA; Obstructive Apnea Hypopnea Index quartile), or (3) central events, central sleep apnea (CSA; Central Apnea Index category), and (4) hypoxia (percentage of sleep time with <90% arterial oxygen percent saturation). Multivariable logistic regression analyses were performed. RESULTS: An increasing RDI quartile was associated with increased odds of AF and CVE (P values for trend, .01 and <.001, respectively). The highest RDI quartile was associated with increased odds of AF (odds ratio [OR], 2.15; 95% confidence interval [CI], 1.19-3.89) and CVE (OR, 1.43; 95% CI, 1.12-1.82) compared with the lowest quartile. An increasing OSA quartile was significantly associated with increasing CVE (P value for trend, .01) but not AF. Central sleep apnea was more strongly associated with AF (OR, 2.69; 95% CI, 1.61-4.47) than CVE (OR, 1.27; 95% CI, 0.97-1.66). Hypoxia level was associated with CVE (P value for trend, <.001); those in the highest hypoxia category had an increased odds of CVE (OR, 1.62; 95% CI, 1.23-2.14) compared with the lowest quartile. CONCLUSIONS: In this large cohort of older men, increasing severity of SDB was associated with a progressive increase in odds of AF and CVE. When SDB was characterized according to central or obstructive subtypes, CVE was associated most strongly with OSA and hypoxia, whereas AF was most strongly associated with CSA, suggesting that different sleep-related stresses may contribute to atrial and ventricular arrhythmogenesis in older men.
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“while in the Outcomes of Sleep Disorders in Older Men Study there was a dose-dependent association of OSA with prevalent AF.720”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [720]
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Citations
Cites
(2000) · PubMed · Cited by 13,173
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678 · cited 1×
“risk factor for overall as well as cardiovascular-specific mortality.(13,14,18) Sleep-”
McNicholas, W. T., Strohl, K. P., White, D. P., Levy, P. A., Schmidt, W., Wheatley, J. R., Redline, S. S., Carley, D. W., Buysse, D. J., Young, T. B., et al. (1999) · PubMed · Cited by 3,665
Self-citationObstructive Sleep Apnea as a Risk Factor for Stroke and Death
Yaggi, H. K., Concato, J., Kernan, W. N., Lichtman, J. H., Brass, L. M., & Mohsenin, V. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043104 · Cited by 3,004
Sleep-disordered Breathing and Cardiovascular Disease
SHAHAR, E., WHITNEY, C. W., REDLINE, S., LEE, E. T., NEWMAN, A. B., JAVIER NIETO, F., O'CONNOR, G. T., BOLAND, L. L., SCHWARTZ, J. E., & SAMET, J. M. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.163.1.2001008 · Cited by 2,901
Self-citationSympathetic neural mechanisms in obstructive sleep apnea.
Somers, V. K., Dyken, M. E., Clary, M. P., & Abboud, F. M. (1995) · Journal of Clinical Investigation · doi:10.1172/jci118235 · Cited by 2,527
Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort
(2008) · Sleep · doi:10.5665/sleep/31.8.1071 · Cited by 1,853 · cited 2×
“risk factor for overall as well as cardiovascular-specific mortality.(13,14,18) Sleep-”
Association of Nocturnal Arrhythmias with Sleep-disordered Breathing
Mehra, R., Benjamin, E. J., Shahar, E., Gottlieb, D. J., Nawabit, R., Kirchner, H. L., Sahadevan, J., & Redline, S. (2006) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200509-1442oc · Cited by 1,262
Self-citationAssociation of Atrial Fibrillation and Obstructive Sleep Apnea
Gami, A. S., Pressman, G., Caples, S. M., Kanagala, R., Gard, J. J., Davison, D. E., Malouf, J. F., Ammash, N. M., Friedman, P. A., & Somers, V. K. (2004) · Circulation · doi:10.1161/01.cir.0000136587.68725.8e · Cited by 1,148
Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation
Gami, A. S., Hodge, D. O., Herges, R. M., Olson, E. J., Nykodym, J., Kara, T., & Somers, V. K. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.08.060 · Cited by 1,104
Day–Night Pattern of Sudden Death in Obstructive Sleep Apnea
Gami, A. S., Howard, D. E., Olson, E. J., & Somers, V. K. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa041832 · Cited by 1,032 · cited 6×
“Complex ventricular ectopy also was strongly associated with overnight hypoxia, a cardinal characteristic of OSA.”
InfluentialObstructive Sleep Apnea and the Recurrence of Atrial Fibrillation
Kanagala, R., Murali, N. S., Friedman, P. A., Ammash, N. M., Gersh, B. J., Ballman, K. V., M. Shamsuzzaman, A. S., & Somers, V. K. (2003) · Circulation · doi:10.1161/01.cir.0000068337.25994.21 · Cited by 983
Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort
Jones, S. (2009) · Yearbook of Pulmonary Disease · doi:10.1016/s8756-3452(08)79181-3 · Cited by 958
Guilleminault, C., Connolly, S. J., & Winkle, R. A. (1983) · The American Journal of Cardiology · doi:10.1016/0002-9149(83)90013-9 · Cited by 934
Sleep Apnea as an Independent Risk Factor for All-Cause Mortality: The Busselton Health Study
(2008) · Sleep · doi:10.5665/sleep/31.8.1079 · Cited by 889
ORWOLL, E. S., Blank, J. B., Barrett-Connor, E. L., Cauley, J. A., Cummings, S. R., Ensrud, K. E., Lewis, C. E., Cawthon, P. M., Marcus, R., Marshall, L. M., et al. (2005) · Contemporary Clinical Trials · doi:10.1016/j.cct.2005.05.006 · Cited by 769 · cited 1×
“The study design and methods of recruitment and demographics of this cohort have been previously published.(24,25) The MrOS Sleep Study (December 2003– March 2005) visit took place an average of 3.”
Self-citationPrognostic Value of Nocturnal Cheyne-Stokes Respiration in Chronic Heart Failure
Lanfranchi, P. A., Braghiroli, A., Bosimini, E., MAZZUERO, G., Colombo, R., Donner, C. F., & Giannuzzi, P. (1999) · Circulation · doi:10.1161/01.cir.99.11.1435 · Cited by 716
Overview of recruitment for the osteoporotic fractures in men study (MrOS)
Blank, J. B., Cawthon, P. M., Carrion-Petersen, M. L., Harper, L., Johnson, J., Mitson, E., & Delay, R. R. (2005) · Contemporary Clinical Trials · doi:10.1016/j.cct.2005.05.005 · Cited by 576 · cited 1×
“The study design and methods of recruitment and demographics of this cohort have been previously published.(24,25) The MrOS Sleep Study (December 2003– March 2005) visit took place an average of 3.”
Methods for Obtaining and Analyzing Unattended Polysomnography Data for a Multicenter Study
Redline, S. S., SANDERS, M. H., Lind, B. K., Quan, S. F., Iber, C., Gottlieb, D. J., BONEKAT, W. H., Rapoport, D. M., Smith, P. L., & Kiley, J. P. (1998) · SLEEP · doi:10.1093/sleep/21.7.759 · Cited by 534
Self-citationDiabetes and Sleep Disturbances
Resnick, H. E., Redline, S., Shahar, E., Gilpin, A., Newman, A., Walter, R., Ewy, G. A., Howard, B. V., & Punjabi, N. M. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.702 · Cited by 504
Self-citationHanly, P. J., & Zuberi, N. (1996) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.153.1.8542128 · Cited by 470
Javaheri, S. (2000) · Circulation · doi:10.1161/01.cir.101.4.392 · Cited by 345 · cited 1×
“These findings are consistent with observations describing reduction in ventricular irritability in those patients with SDB who effectively responded to SDB treatment as gauged by a reduction in RDI and dramatic improvement in hypoxia.(37) To date, the aggregate data suggest the need to more systematically assess whet…”
Reliability of Scoring Respiratory Disturbance Indices and Sleep Staging
Whitney, C. W., Gottlieb, D. J., Redline, S., Norman, R. G., Dodge, R. R., Shahar, E., Surovec, S., & Nieto, F. J. (1998) · Sleep · doi:10.1093/sleep/21.7.749 · Cited by 327 · cited 1×
“99.(27) The severity of SDB was determined by the RDI, which is the number of all apneas (both obstructive and central) and hypopneas that occurred per hour of sleep.”
Self-citationRyan, C. M. (2005) · Thorax · doi:10.1136/thx.2005.040972 · Cited by 266 · cited 1×
“ventricular arrhythmias in patients with heart failure (HF) treated with continuous positive airway pressure.(23) However, it is unclear whether the results from these studies are generalizable to individuals in the community who are less symptomatic or have fewer underlying comorbidities than the typical patients ref…”
Increased Risk of Stroke in Patients With Coronary Artery Disease and Sleep Apnea
Valham, F., Mooe, T., Rabben, T., Stenlund, H. C., Wiklund, U., & Franklin, K. A. (2008) · Circulation · doi:10.1161/circulationaha.108.783290 · Cited by 259
Central Sleep Apnea and Cheyne-Stokes Respiration
Yumino, D., & Bradley, T. D. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200708-129mg · Cited by 236
Cardiac Rhythm Disturbances in the Obstructive Sleep Apnea Syndrome
Harbison, J. A., O’Reilly, P. J., & Nicholas, W. T. M. (2000) · CHEST Journal · doi:10.1378/chest.118.3.591 · Cited by 234
Cardiac Arrhythmias, Snoring, and Sleep Apnea
Hoffstein, V., & Mateika, S. (1994) · CHEST Journal · doi:10.1378/chest.106.2.466 · Cited by 214
Sympathetic Neural Mechanisms in Obstructive Sleep Apnea
Somers, V. K. (1996) · American Journal of Hypertension · doi:10.1016/0895-7061(96)82092-9 · Cited by 195
Sleep Apnea and Cardiac Arrhythmias: Is There a Relationship?
Flemons, W. W., Remmers, J. E., & Gillis, A. M. (1993) · American Review of Respiratory Disease · doi:10.1164/ajrccm/148.3.618 · Cited by 166
Autonomic and hemodynamic responses and interactions during the Mueller maneuver in humans
Somers, V. K., Dyken, M. E., & Skinner, J. L. (1993) · Journal of the Autonomic Nervous System · doi:10.1016/0165-1838(93)90038-v · Cited by 151
Javaheri, S., & Corbett, W. S. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-3-199802010-00006 · Cited by 150
Association Between Atrial Fibrillation and Central Sleep Apnea
Leung, R. S. T., Huber, M. A., Rogge, T., Maimon, N., Chiu, K.-L., & Bradley, T. D. (2005) · SLEEP · doi:10.1093/sleep/28.12.1543 · Cited by 135 · cited 6×
“Complex ventricular ectopy also was strongly associated with overnight hypoxia, a cardinal characteristic of OSA.”
InfluentialAssociation of Nocturnal Arrhythmias with Sleep-disordered Breathing: The Sleep Heart Health Study
Phillips, B. A. (2007) · Yearbook of Pulmonary Disease · doi:10.1016/s8756-3452(08)70447-x · Cited by 126
Association of atrial fibrillation and obstructive sleep apnea
Gami, A. S., Pressman, G., & Caples, S. (2004) · ACC Current Journal Review · doi:10.1016/j.accreview.2004.10.068 · Cited by 104
Obstructive sleep apnea and the recurrence of atrial fibrillation
Kanagala, R. S. D., Narayana, S. M., & Friedman, P. A. (2003) · ACC Current Journal Review · doi:10.1016/j.accreview.2003.08.082 · Cited by 102
Therapy Insight: interactions between atrial fibrillation and obstructive sleep apnea
Gami, A. S., Friedman, P. A., Chung, M. K., Caples, S. M., & Somers, V. K. (2005) · Nature Clinical Practice Cardiovascular Medicine · doi:10.1038/ncpcardio0130 · Cited by 66
Obstructive Sleep Apnea and its Relationship to Cardiac Arrhythmias
Arias, M. A., & Sánchez, A. M. (2007) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2007.00891.x · Cited by 61
Obstructive Sleep Apnea as a Risk Factor for Stroke and Death
&NA; (2006) · Journal of Neurosurgical Anesthesiology · doi:10.1097/00008506-200604000-00010 · Cited by 55
Triggered activity induced by combined mild hypoxia and acidosis in guinea-pig Purkinje fibers
Adamantidis, M. M., Caron, J., & Dupuis, B. (1986) · Journal of Molecular and Cellular Cardiology · doi:10.1016/s0022-2828(86)80432-1 · Cited by 32 · cited 1×
“cal effects of intrathoracic pressure swings, and sympathetic nervous system surges.(19,20)”
Gersh, B. J. (2009) · Yearbook of Cardiology · doi:10.1016/s0145-4145(09)79506-1 · Cited by 26
Relation of Daytime Bradyarrhythmias With High Risk Features of Sleep Apnea
Daccarett, M., Segerson, N. M., Hamdan, A., Hill, B., & Hamdan, M. H. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2007.11.068 · Cited by 22
Wang, T.-M., Luk, H.-N., Sheu, J., Wu, H.-P., & Chiang, C. (2005) · International Journal of Cardiology · doi:10.1016/j.ijcard.2004.10.016 · Cited by 22 · cited 1×
“cal effects of intrathoracic pressure swings, and sympathetic nervous system surges.(19,20)”
Cheitlin, M. D. (2006) · Yearbook of Cardiology · doi:10.1016/s0145-4145(07)70208-3 · Cited by 11
Obstructive sleep apnea in atrial fibrillation patients
Arias, M. A., Alonso‐Fernández, A., Rio, F. G., Sánchez, A., López, J. M., & Vilardebó, C. P. (2005) · International Journal of Cardiology · doi:10.1016/j.ijcard.2005.09.039 · Cited by 9
Obstructive sleep apnoea induced atrial fibrillation
Goldin, J., & Naughton, M. T. (2006) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2006.01000.x · Cited by 7
Excessive sinus pauses and their elimination in a patient with sleep apnea syndrome
Efremidis, M., Sideris, A. M., & Kardaras, F. G. (1998) · International Journal of Cardiology · doi:10.1016/s0167-5273(98)00255-1 · Cited by 4
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Self-citationObstructive sleep apnoea and cardiovascular disease
Sánchez‐de‐la‐Torre, M., Campos‐Rodríguez, F., & Barbé, F. (2012) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(12)70051-6 · Cited by 512
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Benjamin, E. J., Chen, P., Bild, D. E., Mascette, A. M., Albert, C. M., Alonso, Á., Calkins, H. G., Connolly, S. J., Curtis, A. B., Darbar, D., et al. (2009) · Circulation · doi:10.1161/circulationaha.108.825380 · Cited by 477
Linz, D., McEvoy, R. D., Cowie, M. R., Somers, V. K., Nattel, S., Lévy, P., Kalman, J. M., & Sanders, P. (2018) · JAMA Cardiology · doi:10.1001/jamacardio.2018.0095 · Cited by 411
“In 2911 participants of the Outcomes of SleepDisorders in OlderMen study, increasing severity of sleep apneawas associatedwith a progressive increase in the oddsofAFandcardiovascular events.39AlthoughCSAwasvery rare in this study, cardiovascular events were most strongly associated withOSAandhypoxia,whereasAFwasmostst…”
BackgroundInfluentialInternational Consensus Statement on Obstructive Sleep Apnea
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Metadata
- Authors
- Mehra, R., Stone, K. L., Varosy, P. D., Hoffman, A. R., Marcus, G. M., Blackwell, T., Ibrahim, O. A., Salem, R., & Redline, S.
- Affiliations
- Case Western Reserve University (US)
- San Francisco VA Medical Center (US)
- ORCID
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2009-06-22
- Volume
- 169
- Issue
- 12
- Pages
- 1147
- ISSN
- 0003-9926 (ISSN-L)
- PMC
- PMC2802061
- OpenAlex
- W2162509245
- Semantic Scholar
- a6e20afb1823fe86770b9901448e0c1308040351
- Cited by
- 269
- References
- 50
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 10 · 2023: 11 · 2022: 21 · 2021: 15 · 2020: 13 · 2019: 9 · 2018: 16 · 2017: 24 · 2016: 28 · 2015: 20 · 2014: 17 · 2013: 14 · 2012: 16
- FWCI
- 11.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (U01-AG-18197, U01AG018197, U01AG027810)
- National Heart, Lung, and Blood Institute (R01HL070847, R01HL070839, R01HL070838, R01HL070841, R01HL070848, R01HL071194, R01HL070837, R01HL070842, K23HL079114)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR45614, U01-AR45632, U01 AR45647, U01AR045583, U01 AR-45583, U01-AR-45654, U01AR045580, U01AR045632, U01AR045654, U01AR045614, U01AR045647, U01AR066160, U01AR45580)
- National Center for Research Resources (UL1RR024140)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- obstructive sleep apnea, central sleep apnea, atrial flutter, nocturnal arrhythmia, hypoxemia, older men, respiratory disturbance index, apnea-hypopnea index, central apnea index, arrhythmia risk
- MeSH terms
- Aged, Arrhythmias, Cardiac, Circadian Rhythm, Electrocardiography, Follow-Up Studies, Heart Rate, Humans, Male, Retrospective Studies, Sleep Wake Disorders, Time Factors, United States, Prevalence, Odds Ratio, Polysomnography
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