Journal of Sleep Disorders: Treatment and CareISSN: 2325-9639

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Research Article, J Sleep Disor Treat Care Vol: 4 Issue: 2

Obstructive Sleep Apnea is Associated with Increased Frequency of Nocturnal Cardiac Arrhythmias

Davies SE1, Turton AR2, DMonte N3, Hamilton GS2,4 and O’Driscoll DM4,5*
1Department of General Medicine, Monash Health, Victoria, Australia
2Monash Lung and Sleep, Monash Health, Victoria, Australia
3Monash Heart, Monash Health, Victoria, Australia
4Department of Medicine, School of Clinical Sciences, Monash University, Victoria, Australia
5Department of Respiratory and Sleep Medicine, Eastern Health, Victoria, Australia
Corresponding author : Dr Denise M O’Driscoll
Department of Respiratory and Sleep Medicine Eastern Health, 8 Arnold St., Box Hill 3128, Australia
Tel: +61 (0)39975 6538
E-mail: [email protected]
Received: March 02, 2015 Accepted: June 01, 2015 Published: June 03, 2015
Citation: Davies SE, Turton AR, DMonte N, Hamilton GS, O’Driscoll DM (2015) Obstructive Sleep Apnea is Associated with Increased Frequency of Nocturnal Cardiac Arrhythmias. J Sleep Disor: Treat Care 4:2. doi:10.4172/2325-9639.1000155

Abstract

Obstructive Sleep Apnea is Associated with Increased Frequency of Nocturnal Cardiac Arrhythmias

Objectives: Obstructive sleep apnea (OSA) is associated with increased cardiovascular mortality secondary to ischaemic heart disease and stroke. Evidence surrounding cardiac arrhythmia is limited and conflicting. We aimed to test the hypothesis that patients with OSA have an increased frequency of nocturnal cardiac arrhythmias compared to those without OSA. Secondly, to determine if CPAP reduces the frequency of OSA associated arrhythmias.
Methods: 61 patients with an AHI <5events/hr (No OSA) and 72 patients with an AHI >20 events/hr (moderate to severe OSA) were included from consecutive referrals for suspected OSA. 28 patients with moderate-severe OSA returned for further overnight study with CPAP. The electrocardiogram from polysomnography (PSG) was reviewed for cardiac arrhythmias whilst blinded to subject group.
Results: Significantly more subjects in the OSA group had arrhythmia compared with the no-OSA group (74% vs. 56%, p<0.05). Significantly more subjects in the OSA group exhibited ventricular premature complexes (VPCs) (18% vs. 5%, p<0.05). Stepwise multiple linear regression found OSA was the only significant independent predictor for VPCs. There was no significant difference in the percentage of subjects identified with non-sustained ventricular tachycardia, atrial premature complexes, atrial fibrillation, or heart block. There was no significant difference in arrhythmia with CPAP.
Conclusion: Individuals with moderate or severe OSA are atincreased risk of VPCs, which may predispose this group to further significant cardiac arrhythmias, and subsequently be a contributory factor to the increased morbidity and mortality seen in this patient group.  

Keywords: Sleep apnea; Arrhythmia; Ventricular; Cardiac

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