ArticleSleep2025
Polysomnographic sleep architectural disruption associated with atrial fibrillation development.
Article in Sleep, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Influence of sleep architectural disruptions on the evolution of atrial fibrillation.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
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Authors and funding
10 authors.
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Abstract
STUDY
objectivesTo examine the unclear, inconsistent role of sleep architectural disruption in atrial fibrillation (AF) development.
methodsPatients (age ≥ 18 years) who underwent in-laboratory sleep studies at Cleveland Clinic 2000-2015 were examined (follow-up: 7.8 ± 3.5 years). Primary predictors were arousal index and total sleep time. Secondary predictors included sleep efficiency, wakefulness after sleep onset, sleep and REM latency, and percentage of each sleep stage. Predictors were fit to Cox proportional hazard models predicting time from sleep study to AF by diagnosis code. Covariates included demographics, anthropometrics, tobacco use, sleepiness, apnea-hypopnea index, sleep apnea-specific hypoxic impact, cardiovascular risk factors and disease, mood disorders, medications, and positive airway pressure.
resultsIn our cohort (n = 27 232, age: 49.4 ± 14.5 years, 43.7% male, 73.9% white), 2077 (7.6%) developed incident AF. Arousal index was not associated with AF incidence. For every hour of decreased total sleep time, AF incidence increased 8% (HR = 1.08, 95% CI = 1.04 to 1.11). For every 10-unit decrease in sleep efficiency, AF incidence increased 6% (HR = 1.06, 95% CI = 1.04 to 1.09). For every hour of increased wakefulness after sleep onset, AF incidence increased 11% (HR = 1.11, 95% CI = 1.05 to 1.16). For every 10-unit increase in percent N1, AF incidence increased 6% (HR = 1.06, 95% CI = 1.01 to 1.10).
conclusionsLess sleep time and greater sleep disruption were associated with increased incident AF in this large clinical cohort. These results suggest that sleep macro-architecture can influence AF development. Mechanistic and prospective studies are needed to verify whether sleep disruption is a novel target for AF prevention.
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