Association between insomnia and atrial fibrillation in a Chinese population: A cross‐sectional study

Abstract

Background Insomnia is the most prevalent sleep disorder; however, little research has explored the link between insomnia and atrial fibrillation (AF). Hypothesis Insomnia is associated with increased risk of AF in a Chinese population. Methods A total of 8371 Chinese participants (4314 males; mean age, 42.4 ± 13.1 years) were enrolled in this cross‐sectional study to investigate the association between insomnia and AF. AF was assessed in a standard supine resting position with a 10‐s 12‐lead electrocardiograph (ECG) or by self‐reported history. Insomnia was assessed using the Athens Insomnia Scale (AIS), and a score of ≥6 was regarded as having insomnia. The association between insomnia and AF was determined by logistic regression analysis. Results Among the 8371 subjects, 1074 (12.8%) had different degrees of insomnia, and AF was observed in 50 subjects (0.60%). After adjusting for potential confounders, individuals with insomnia had moderately increased likelihood of suffering from AF compared with those without insomnia (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.00‐3.70, P = 0.05). After stratifying data by age, a significant positive association was found in those age <40 years (OR: 6.52, 95% CI: 1.64‐25.83, P = 0.01), and a similar trend existed in males after stratifying by sex, although this relationship was not statistically significant (OR: 2.11, 95% CI: 0.92‐4.83, P = 0.08). Conclusions Individuals with insomnia may have a higher risk of AF in the particular Chinese population assessed in this study. Age (<40 years) is a significant factor in the association between insomnia and AF.

Lipid profile and incidence of atrial fibrillation: A prospective cohort study in China

“…12 According to the European Society of Cardiology guidelines, a diagnosis of AF was considered when all the following ECG criteria were met: (1) irregular R-R intervals, (2) absence of repeating P waves, and (3) irregular atrial activity. 13 For confirmation of diagnosis in such cases, the ECG was reviewed by 2 cardiologists.…”

Associations of sleep quality with incident atrial fibrillation: a meta‐analysis

“…Thus, the final analysis included eight articles, 21-28 including 10 observational studies (seven cohort studies 21,22,24,25,27,28 and three cross-sectional studies 23,25,26 ) with 14 296 314 individuals. After the exclusion of 1560 articles as they were case reports, correspondences, review articles, in vitro studies, animal studies or interventional studies, there were 31 articles for full-length review.…”

“…Compared to individuals without insomnia, those who had insomnia carried a 1.3-fold increased risk of incident AF. [42][43][44][45][46] Table 2 Main characteristics of the studies included in meta-analysis of associations of atrial fibrillation (AF) with insomnia, and/or frequent awakening Christensen et al 25 Han et al 26 Lee et al 27 Christensen et al 25 Christensen Impaired glucose tolerance and increased inflammatory markers, such as C-reactive protein, tumour necrosis factor-alpha and interleukin 6 have been found in patients with sleep-related disorders. Multiple mechanisms are postulated to be responsible for AF occurrence by these sleep characteristics.…”

“…25 Although arousal index is part of OSA physiological variables, 11 included studies did not provide data on frequent night awakening related to OSA. [21][22][23][24][25][26][27][28] …”

“…2,5,6 Sleep is a dynamic and complex process. [21][22][23][24][25][26][27][28] However, the relationship between these sleep quality problems and AF remains unclear, with conflicting findings from previous studies. 7 Recently, accumulated evidence of sleep disorders and their association with arrhythmia is reported, 8,9 especially obstructive sleep apnoea (OSA).…”