Sleep apnea increases the risk of new hospitalized atrial fibrillation: a historical cohort study

Recent research has identified obstructive sleep apnoea (OSA) as a possible risk factor for atrial fibrillation (AF), with studies showing a reduction in recurrent AF as a result of OSA treatment. However, research examining the longitudinal relationship between OSA and incident AF is limited. In this historical cohort study, researchers aimed to examine the relationship between newly diagnosed OSA and incident AF over 10 years. A total of 8,256 patients were included in the analysis, all of who were arrhythmia-free at baseline (i.e. the time of the first diagnostic sleep study). Results demonstrated that, over a median follow-up of 10 years, 2.1% of the cohort were hospitalised for AF. Despite this relatively low incidence rate, a statistically significant relationship was found between severe nocturnal hypoxemia and AF after controlling for factors such as age, sex, alcohol consumption and smoking status. Based on these findings, researchers stated that nocturnal hypoxemia was an independent predictor of incident hospitalisation for AF in patients with suspected OSA. They further claimed that the reduced risk for AF hospitalisation found in this analysis may be the result of the younger age and lower BMI of the participants. Based on this, researchers concluded that there is a relationship between OSA, nocturnal hypoxemia and development of AF, recommending that patients with OSA should be identified as those who are at risk of developing AF.