Sleep and biological rhythms · 2026
Relationship between Positional Obstructive Sleep Apnea and Excessive Daytime Sleepiness in Patients with Atrial Fibrillation.
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Liu Xiaoyue, Stafford Patrick, Bilchick Kenneth, Mazimba Sula, Logan Jeongok, Cho Yeilim, Patel Paras, Walker McCall, Healy William, Kwon Younghoon
Аннотация
PURPOSE: Obstructive sleep apnea (OSA) is highly prevalent in patients with atrial fibrillation (AF). Prior studies suggest that excessive daytime sleepiness (EDS), a common symptom of OSA, is less pronounced in patients with AF. This study focused on a subtype of OSA, positional OSA (POSA), and examined its association with EDS overall and separately in patients with and without AF.
METHODS: This study included 222 OSA patients with and without AF history who underwent in-lab polysomnography. POSA was defined using three criteria: conventional POSA (cPOSA; supine/non-supine apnea-hypopnea index [AHI] ratio ≥ 2), intermediately conservative POSA (iPOSA; supine/non-supine AHI ratio ≥ 3), and exclusive POSA (ePOSA; supine/non-supine AHI ratio ≥ 2 and non-supine AHI < 5 events/h). EDS was determined by an Epworth Sleepiness Scale score ≥ 11. Logistic regression was performed to assess the associations.
RESULTS: Overall, 55.4% of patients had cPOSA, and 43.6% reported EDS. Analysis of the entire cohort showed that patients with cPOSA (adjusted odds ratio [aOR]: 0.51, 95% confidence interval [CI]: 0.26-0.98) or iPOSA (aOR: 0.37, 95% CI: 0.18-0.74) had lower odds of EDS than their non-POSA counterparts. Among patients with AF, cPOSA was associated with lower odds of EDS (aOR: 0.32, 95% CI: 0.11-0.90). Among patients without AF, iPOSA was associated with lower odds of EDS (aOR: 0.28, 95% CI: 0.10-0.75).
CONCLUSION: The association between POSA and EDS varied by POSA definitions and AF status. The findings suggest that EDS manifests differently by cPOSA status in patients with AF.
METHODS: This study included 222 OSA patients with and without AF history who underwent in-lab polysomnography. POSA was defined using three criteria: conventional POSA (cPOSA; supine/non-supine apnea-hypopnea index [AHI] ratio ≥ 2), intermediately conservative POSA (iPOSA; supine/non-supine AHI ratio ≥ 3), and exclusive POSA (ePOSA; supine/non-supine AHI ratio ≥ 2 and non-supine AHI < 5 events/h). EDS was determined by an Epworth Sleepiness Scale score ≥ 11. Logistic regression was performed to assess the associations.
RESULTS: Overall, 55.4% of patients had cPOSA, and 43.6% reported EDS. Analysis of the entire cohort showed that patients with cPOSA (adjusted odds ratio [aOR]: 0.51, 95% confidence interval [CI]: 0.26-0.98) or iPOSA (aOR: 0.37, 95% CI: 0.18-0.74) had lower odds of EDS than their non-POSA counterparts. Among patients with AF, cPOSA was associated with lower odds of EDS (aOR: 0.32, 95% CI: 0.11-0.90). Among patients without AF, iPOSA was associated with lower odds of EDS (aOR: 0.28, 95% CI: 0.10-0.75).
CONCLUSION: The association between POSA and EDS varied by POSA definitions and AF status. The findings suggest that EDS manifests differently by cPOSA status in patients with AF.