It's time to wake up!: sleep apnea and cardiac arrhythmias

Abstract

Obstructive sleep apnea (OSA) syndrome is a common breathing disorder, affecting ∼5% of North American adults, the prevalence in men being almost twice that of women.1 The diagnosis is suspected by history and often body habitus, but requires confirmation with a formal sleep study. Polysomnography is the gold-standard study for the diagnosis of OSA. It determines the severity of OSA by measuring the apnea-hypopnoea index (AHI), which is the number of apnoeic and hypopnoeic episodes that occur during 1 h. The condition is associated with increased cardiovascular morbidity and mortality, somnolence, neurocognitive dysfunction, mood disorders, and an increased risk of motor vehicle accidents; despite this, it is usually under-diagnosed (20–30% depending on clinical scenario).2–8 Researchers have demonstrated an increased incidence of cardiac arrhythmias among patients with OSA.9 Interestingly, however, there has been no systematic effort to identify the prevalence of OSA among patients with cardiac arrhythmias. Early reports described an increased association between OSA and bradyarrhythmias.10 This led to an intense focus on the role of pacemakers as …