Association of Sleep Apnea and Snoring with Incident Atrial Fibrillation in the Multi-Ethnic Study of Atherosclerosis

Gen Min Lin, Laura A. Colangelo, Donald M. Lloyd-Jones, Susan Redline, Joseph Yeboah, Susan R. Heckbert, Saman Nazarian, Alvaro Alonso, David A. Bluemke, Naresh M. Punjabi, Moyses Szklo, Kiang Liu

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

The association between sleep apnea and atrial fibrillation (AF) has not been examined in a multiethnic adult population in prospective community-based studies. We prospectively (2000-2011) investigated the associations of physician-diagnosed sleep apnea (PDSA), which is considered more severe sleep apnea, and self-reported habitual snoring without PDSA (HS), a surrogate for mild sleep apnea, with incident AF in white, black, and Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease at baseline (2000-2002). Cox proportional hazards models were used to assess the associations, with adjustment for socioeconomic status, traditional vascular disease risk factors, race/ethnicity, body mass index, diabetes, chronic kidney disease, alcohol intake, and lipid-lowering therapy. Out of 4,395 respondents to a sleep questionnaire administered in MESA, 181 reported PDSA, 1,086 reported HS, and 3,128 reported neither HS nor PDSA (unaffected). Over an average 8.5-year follow-up period, 212 AF events were identified. As compared with unaffected participants, PDSA was associated with incident AF in the multivariable analysis, but HS was not (PDSA: hazard ratio = 1.76, 95% confidence interval: 1.03, 3.02; HS: hazard ratio = 1.02, 95% confidence interval: 0.72, 1.44). PDSA, a marker of more severe sleep apnea, was associated with higher risk of incident AF in this analysis of MESA data.

Original languageEnglish (US)
Pages (from-to)49-57
Number of pages9
JournalAmerican journal of epidemiology
Volume182
Issue number1
DOIs
StatePublished - Jul 1 2015

Keywords

  • atrial fibrillation
  • longitudinal studies
  • sleep apnea
  • snoring

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