Occurrence of poor sleep quality in atrial fi brillation patients according to the EHRA score

Abstract

Background Atrial fibrillation (AF) is the most common arrhythmia that affects the quality of life by causing deleterious health consequences, and impairing sleep quality. The severity of AF symptoms may range from very mild to the very intense which can be assessed by the European Heart Rhythm Association (EHRA) score. The aim of the study was to assess the prevalence of poor sleep quality in AF patients, in relation to the symptom severity based on the EHRA score.Methods 177 consecutive patients, hospitalized between 2011 and 2013 with non-valvular AF and no history of myocardial infarction, stroke or decompensation of heart failure within the last 6 months, were enrolled into the study. Sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI) in all patients at admission. Medical history and data concerning AF symptoms and severity by the EHRA score were gathered by a qualified physician.Results Poor sleep quality was present in 49.7% of patients. Patients with poor sleep quality were more often females (66.6% vs. 35.8%; P= 0.007), were older (57.9 ± 10.1 vs. 53.9 ± 10.0 years; P= 0.005), and had higher systolic blood pressures (134.4 ± 16.4 vs. 129.8 ± 17.8 mmHg; P= 0.03). Poor sleep quality was present in 33.3% of the EHRA I group, 43.9% of the EHRA II group, 58.1% of the EHRA III group, and 61.5% of the EHRA IV group (p value for trend 0.01).Conclusions Poor sleep quality is highly prevalent in AF patients, affecting approximately half of them. It is related to the severity of symptoms, and prevalence rises with every degree of the EHRA score.