Longitudinal relationships of periodic limb movements during sleep and incident atrial fibrillation.

ABSTRACT: This study aimed to examine relationship between periodic limb movements during sleep (PLMS) and incident atrial fibrillation/flutter (AF).Prospective multicenter cohort (n?=?2273: adjudicated AF group; n?=?843: self-reported AF group) of community-dwelling men without prevalent AF were followed for an average of 8.3 years (adjudicated) and 6.5 years (self-reported). PLMS index (PLMI, <5 (ref), ?5 to <30, ?30) and PLM arousal index (PLMAI, <1 (ref), ?1 to <5, ?5) were measured by polysomnography. Incident adjudicated and self-reported AF were analyzed by Cox proportional hazards and logistic regression, respectively, and adjusted for age, clinic, race, body mass index (BMI), alcohol use, cholesterol level, cardiac medications, pacemaker, apnea-hypopnea index, renal function, and cardiac risk. The interaction of age and PLMS was examined.In this primarily Caucasian (89.8%) cohort of older men (mean age 76.1?±?5.5 years) with BMI of 27.2?±?3.7, there were 261 cases (11.5%) of adjudicated and 85 cases (10.1%) of self-reported incident AF. In the overall cohort, PLMI and PLMAI were not associated with adjudicated or self-reported AF. There was some evidence of an interaction of age and PLMI (p?=?0.08, adjudicated AF) and PLMAI (p???0.06, both outcomes). Among men aged ?76 years, the highest PLMI tertile was at increased risk of adjudicated AF (?30 vs. <5; hazard ratio (HR)?=?1.63, 1.01-2.63) and the middle PLMAI tertile predicted increased risk of both outcomes (1 to <5 vs. <1; adjudicated, HR?=?1.65, 1.05-2.58; self-reported HR?=?5.76, 1.76-18.84). No such associations were found in men aged <76 years.Although PLMS do not predict AF incidence in the overall cohort, the findings suggest PLMS increases incident AF risk in the older subgroup.

SUBMITTER: May AM 

PROVIDER: S-EPMC5126983 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature