Should I evaluate my patient with atrial fibrillation for sleep apnea?

[摘要] The prevalence of sleep apneais exceedingly high in patients withatrial fi brillation—50% to 80% compared with30% to 60% in respective control groups.1–3Conversely, atrial fi brillation is more prevalent in those with sleep-disordered breathingthan in those without (4.8% vs 0.9%).4 Sleep-disordered breathing comprises obstructive sleep apnea and central sleep apnea.Obstructive sleep apnea, characterized by repetitive upper-airway obstruction during sleep,is accompanied by intermittent hypoxia, risesin carbon dioxide, autonomic nervous systemfl uctuations, and intrathoracic pressure alterations.5 Central sleep apnea may be neurallymediated and, in the setting of cardiac disease,is characterized by alterations in chemosensitivity and chemoresponsiveness, leading to astate of high loop gain—ie, a hypersensitiveventilatory control system leading to ventilatory drive oscillations.

[学科分类] 卫生学