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Older Men With Sleep Apnoea More Likely to Have Arrhythmias CHICAGO -- June 22, 2009 -- Increasingly severe sleep-related breathing disorders in older men appear to be associated with a greater risk of arrhythmias, according to a study published in the June 22 issue of Archives of Internal Medicine. In addition, different types of breathing problems appear more closely associated with different categories of arrhythmia. Reena Mehra, MD, Case Western Reserve University School of Medicine, Cleveland, Ohio, and colleagues studied 2,911 men who underwent sleep testing by polysomnography between 2003 and 2005. The number of times they experienced apnoea or hypopnoea during sleep was recorded, as were any periods of time in which the oxygen level of blood in their arteries dipped below 90%. Having more episodes of paused or shallow breathing was associated with increased odds of 2 types of arrhythmias -- 1 involving the atria and 1 involving the ventricles. Obstructive sleep apnoea was associated with irregular heartbeats caused by a problem with the lower chambers or ventricles. Lower blood oxygen levels also appeared to be associated with this type of arrhythmia. However, central sleep apnoea was more strongly associated with arrhythmias in the atria or upper chambers. More severe cases of sleep-disordered breathing were associated with higher odds of arrhythmia; in addition, “there also seems to be a threshold effect such that moderate-to-severe sleep-disordered breathing confers the greatest increased odds of clinically significant arrhythmias independent of self-reported heart failure and cardiovascular disease,” the authors wrote. “This line of investigation also identified hypoxia as the possible culprit pathophysiologic characteristic of sleep-disordered breathing that may serve as the trigger of ventricular cardiac arrhythmia development in older men.” “The strong associations between central sleep apnoea and atrial fibrillation suggest that central sleep apnoea may be a sensitive marker of underlying abnormalities in autonomic or cardiac dysfunction associated with atrial fibrillation,” they concluded. “Further prospective and intervention studies are needed to better determine causality and the impact of aggressive sleep-disordered breathing interventions on cardiac outcomes.” SOURCE: Archives of Internal Medicine E-mail this page to a friend or colleague! To print, use this version