Healthy sleep pattern could ward off AF recurrence after catheter ablation
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A healthy sleep pattern, as well as improving sleep habits, were associated with a lower risk for atrial fibrillation recurrence in patients who underwent catheter ablation for AF, researchers reported.
Data from the single-center study also showed three sleep behaviors — “adequate sleep duration,” “no insomnia” and “no excessive daytime sleepiness” — rather than self-identifying as a “morning chronotype” or “no snoring” were associated with a lower risk for AF recurrence.
Data were derived from Cang J, et al. Clin Cardiol. 2023;doi:10.1002/clc.23975.
“Emerging evidence has associated several sleep behaviors such as excessive daytime sleepiness, sleep quality, sleep duration and insomnia with episodes of AF,” Long Chen, PhD, of the department of cardiology at Zhongda Hospital of Southeast University, Nanjing, China, and colleagues wrote in the study background. “Sleep disorders can alter the activation of sympathetic nerves and increase inflammation and oxidative stress, which would also increase the risk of AF recurrence. Notably, different sleep behaviors are intrinsically linked, so different trials which focus on the same sleep behavior would show contradictory results. Theoretically, it is more reasonable to pool different sleep behaviors together when exploring the influence of sleep on the recurrence of AF.”
In a retrospective study, Cheng and colleagues analyzed data from 416 participants who underwent successful catheter ablation (radiofrequency or cryoballoon ablation) at Zhongda Hospital of Southeast University. Researchers assessed sleep patterns via questionnaires that included questions to define chronotype, sleep duration, presence of insomnia, snoring and daytime sleepiness.
The findings were published in Clinical Cardiology.
Within the cohort, 208 participants had a healthy sleep pattern within a mean follow‐up of 32.42 months.
The observed number of patients with AF recurrence was 50%, 42.6% and 19.2% in unhealthy, intermediate and healthy sleep groups, respectively (P < .01). After adjustments for covariates, an unhealthy sleep pattern was associated with AF recurrence, with an HR of 3.47 (95% CI, 1.726-6.979; P < .001).
Parameters such as adequate sleep duration (HR = 0.53; 95% CI, 0.36-0.79), no insomnia (HR = 0.47; 95% CI, 0.32-0.68) and no excessive daytime sleepiness (HR = 0.61; 95% CI, 0.41-0.89) were associated with lower risk for AF recurrence, whereas morning chronotype and no snoring were not associated with recurrent AF, according to the researchers.
“Various sleep behaviors may affect the development of cardiac arrhythmias via different and complementary pathways, so it is not surprising that their associations with recurrence exhibit an additive fashion when analyzed as a unit in the sleep pattern, as observed in our study,” the researchers wrote.
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