Revista de trastornos del sueño: tratamiento y cuidados

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

Davies SE, Turton AR, DMonte N, Hamilton GS and O?Driscoll DM

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.