Sleep characteristics that predict atrial fibrillation

Christensen, Merrill J.; Dixit, Shalini; Dewland, Thomas A.; Whitman, Isaac R.; Nah, Gregory; Vittinghoff, Eric; Mukamal, Kenneth J.; Redline, Susan; Robbins, John A.; Newman, Anne B.; Patel, Sanjay R.; Magnani, Jared W.; Psaty, Bruce M.; Olgin, Jeffrey E.; Pletcher, Mark J.; Heckbert, Susan R.; Marcus, Gregory M.

doi:10.1016/j.hrthm.2018.05.008

Cited by 62 publications

(48 citation statements)

References 32 publications

(39 reference statements)

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“…Yet , it is possible that differences in HF or comorbidity between CBT-I and attention-control groups or unmeasured differences in HF contributed to our findings.. Other HF and cardiovascular characteristics (e.g., dysrhythmias) should be considered in more detail in future studies. For example, recent evidence suggest that atrial fibrillation contributes to insomnia (Chokesuwattanaskul et al, 2018;Christensen et al, 2018;Han et al, 2017;Lee et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Effects of Cognitive Behavioral Therapy for Insomnia on Sleep, Symptoms, Stress, and Autonomic Function Among Patients With Heart Failure

Redeker¹,

Conley

Anderson³

et al. 2018

Behavioral Sleep Medicine

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Background: Insomnia is common among patients with stable heart failure (HF) and associated with inflammation and altered autonomic function. Purpose: The purposes of this study were to examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on the Hypothalamic Pituitary (HPA) Axis, autonomic function, inflammation and circadian rhythmicity and the associations between these biomarkers and insomnia, sleep characteristics, symptoms, functional performance, and sleep-related cognitions. Methods: We conducted a sub-analysis of a pilot randomized controlled trial (RCT) (NCT02827799) whose primary aim was to test the effects of CBT-I on insomnia. We randomized 51 patients with stable Class II-IV HF to CBT-I (n = 30) or attention control (n = 21). Participants completed wrist actigraphy and self-reported insomnia severity, sleep characteristics, sleep-related cognitions, daytime symptoms, and functional performance. We measured day and nighttime urinary free cortisol, melatonin sulfate, epinephrine and norepinephrine at baseline and 2 weeks after CBT-I and computed general linear models and partial correlations. Results: CBT-I had no effects on the biomarkers, but there were statistically significant negative cross-sectional correlations between the ratio of day/night urinary free cortisol and sleep

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Section: Discussionmentioning

confidence: 99%

Effects of Cognitive Behavioral Therapy for Insomnia on Sleep, Symptoms, Stress, and Autonomic Function Among Patients With Heart Failure

Redeker¹,

Conley

Anderson³

et al. 2018

Behavioral Sleep Medicine

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show abstract

“…A recent observational study showed that lack of rapid eye movement sleep is associated with an increased risk of incident AF [26]. Both subjectively reported sleep difficulty and objectively assessed short sleep duration have been linked to AF [26,27]. These findings highlight the complex interplay between sleep in its entirety and AF [20].…”

Section: Sleep Apnea and Atrial Fibrillationmentioning

confidence: 97%

“…Lack of deep sleep was found to be more common in patients with AF independent of OSA [24,25]. A recent observational study showed that lack of rapid eye movement sleep is associated with an increased risk of incident AF [26]. Both subjectively reported sleep difficulty and objectively assessed short sleep duration have been linked to AF [26,27].…”

Section: Sleep Apnea and Atrial Fibrillationmentioning

confidence: 99%

Sleep Apnea and Heart

et al. 2019

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Scientific investigations in the past few decades have supported the important role of sleep in various domains of health. Sleep apnea is a highly prevalent yet underdiagnosed sleep disorder representing a valid cardiovascular risk factor, particularly for hypertension. While several studies have demonstrated the benefits of sleep apnea treatment on subclinical cardiovascular measures, there is a paucity of studies proving reduction of cardiovascular events and mortality. Sufficient and highquality sleep is also important in the maintenance of cardiovascular health. Future investigations should focus on improving identification of patients at greatest risk of adverse cardiovascular sequelae of sleep apnea and testing the therapeutic benefit of sleep apnea treatment in this vulnerable group.

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“…Initially informed by the observation that self-report of frequent nighttime awakening was associated with prevalent AF in the Health eHeart Study, we subsequently showed that a similar self-report of nighttime awakening predicted incident AF in the Cardiovascular Health Study. 5 In both cases, relationships persisted after adjusting for conventional AF risk factors, including available evidence of OSA. We then analyzed 1,127 Cardiovascular Health Study participants in the subcohort of the Sleep Heart Health Study and found that decreased rapid eye movement (REM) sleep was significantly predictive of incident AF after adjusting for potential confounders, including polysomnogram-based OSA indices collected concurrently.…”

mentioning

confidence: 92%