None listed
Conditions
Brief summary
Sleep-disordered breathing (SDB) is common in patients with atrial fibrillation (AF) and is associated with poor clinical outcomes. International AF management guidelines advocate for the interrogation for clinical signs of SDB when addressing AF risk factors given the important interplay between SDB and AF. Excessive daytime sleepiness is an important clinical consequence of SDB and its presence can be a key consideration in patient selection for SDB investigation and management. However, patients with cardiovascular disease report low levels of daytime sleepiness. Therefore, relying on self-reported daytime sleepiness in patient selection for diagnosis and management can potentially result in a significant proportion of patients not being identified with SDB or provided appropriate management opportunities. We hypothesise that in patients with atrial fibrillation, excessive daytime sleepiness is low and that self-reported sleepiness correlates poorly with the presence or degree of SDB. We aim to test this hypothesis by studying patients with AF who have undergone overnight sleep studies. We will assess the self-reported sleepiness and its correlation to the presence and degree of SDB. We will test the utility of the Epworth Sleepiness Scale, a widely used tool to quantify daytime sleepiness, to predict the presence of SDB. Further, we aim to characterise clinical features that can help identify patients with significant SDB, and assess the potential impact this would have on AF management.
Interventions
Patients with a atrial fibrillation, a common heart rhythm abnormality, are often referred for formal sleep studies (polysomnography) to assess for the presence and severity of sleep-disordered breathing. Sleep-disordered breathing, of which sleep apnoea is an important subtype, is a known risk factor for developing atrial fibrillation and its treatment can improve the likelihood of maintaining normal sinus rhythm following atrial fibrillation treatment. One of the main clinical consequences of
Patients with a atrial fibrillation, a common heart rhythm abnormality, are often referred for formal sleep studies (polysomnography) to assess for the presence and severity of sleep-disordered breathing. Sleep-disordered breathing, of which sleep apnoea is an important subtype, is a known risk factor for developing atrial fibrillation and its treatment can improve the likelihood of maintaining normal sinus rhythm following atrial fibrillation treatment. One of the main clinical consequences of sleep-disordered breathing is excessive daytime sleepiness which can be assessed using questionnaires. The polysomnography tests are usually performed overnight in a specialised sleep centre and are reported by a qualified sleep technician and a respiratory physician. The duration of observation spans over the recruitment period which is from January 2012 to March 2017. The electronic health records of the study patients will be examined and the following parameters (already present health records) retrieved for analysis: medical background (clinical history), antrhopometric data (weight, height and BMI), medication history, echocardiographic data, clinical questionnaires (AF severity questionnaires and sleepiness questionnaires) as well as the formal polysomnography reports. These data are already present in electronic format in medical records and will be accessed to retrieve the relevant information for the study once approved.
Sponsors
Professor Prashanthan Sanders
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Age equal to or greater than 18 years • Diagnosed with paroxysmal or persistent atrial fibrillation (according to the 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. • Referred to, and completed, a formal overnight polysomnography (PSG) • Completed a contemporaneous Epworth Sleepiness Scale questionnaire
Exclusion criteria
• Insufficient polysomnography data (less than 4 hours of sleep study or absence of measured apnoea-hypopnoea index reporting). • Incomplete Epworth Sleepiness Scale score • Pregnancy
Outcome results
None listed