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Race, Sex, Age, and Regional Differences in the Association of Obstructive Sleep Apnea With Atrial Fibrillation: Reasons for Geographic and Racial Differences in Stroke Study.
- Source :
-
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2018 Sep 15; Vol. 14 (9), pp. 1485-1493. Date of Electronic Publication: 2018 Sep 15. - Publication Year :
- 2018
-
Abstract
- Study Objectives: To examine the cross-sectional association between obstructive sleep apnea (OSA) risk and atrial fibrillation (AF) in the REasons for Geographic And Racial Differences in Stroke (REGARDS), a cohort of black and white adults.<br />Methods: Using REGARDS data from subjects recruited between 2003-2007, we assessed 20,351 participants for OSA status. High OSA risk was determined if the participant met at least two criteria from the Berlin Sleep Questionnaire (persistent snoring, frequent sleepiness, high blood pressure, or obesity). AF was defined as a self-reported history of a previous physician diagnosis or presence of AF on electrocardiogram. Logistic regression was used to determine odds ratio and 95% confidence interval for the association between OSA status and AF with subgroup analysis to examine effect modification by age, race, sex, and geographical region.<br />Results: The prevalence of AF was 7% (n = 1,079/14,992) and 9% (n = 482/5,359) in participants at low and high risk of OSA, respectively ( P < .0001). Persons at high risk of OSA had greater prevalence of diabetes and stroke history, and were more likely to be obese and taking sleep medications. In a multivariable analysis adjusted for demographics, cardiovascular risk factors, and potential confounders, high risk for OSA was associated with an increased odds of AF compared to low risk for OSA (odds ratio = 1.27, 95% confidence interval = 1.13, 1.44). This association differed significantly only by race ( P for interaction = .0003). For blacks, there was a significant 58% increase in odds of AF in participants at high risk versus low risk of OSA, compared to a nonsignificant 12% increase in odds in whites. We were limited by self-reported variables, inability to adjust for obesity, and the cross-sectional nature of our study.<br />Conclusions: High risk of OSA is associated with prevalent AF among blacks but not whites.<br />Commentary: A commentary on this article appears in this issue on page 1459.<br /> (© 2018 American Academy of Sleep Medicine.)
- Subjects :
- Age Factors
Cohort Studies
Comorbidity
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Prevalence
Prospective Studies
Risk Factors
Sex Factors
Stroke epidemiology
Surveys and Questionnaires
United States epidemiology
Black or African American statistics & numerical data
Atrial Fibrillation epidemiology
Sleep Apnea, Obstructive epidemiology
White People statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1550-9397
- Volume :
- 14
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 30176963
- Full Text :
- https://doi.org/10.5664/jcsm.7320