{"title":"睡眠片段化与房颤事件的关系：一项社区人群的前瞻性队列研究。","authors":"Lixia Wang, Xinjie Hui, Rong Huang, Yi Xiao","doi":"10.5664/jcsm.11614","DOIUrl":null,"url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep fragmentation (SF) has been recognized as a risk factor for cardiovascular disease. This study aims to investigate the impact of SF on atrial fibrillation (AF).</p><p><strong>Methods: </strong>A total of 2,377 participants without pre-existing AF from the Sleep Heart Health Study were enrolled in this study. Wake after sleep onset (WASO), SF index, arousal index, and sleep efficiency were used to describe SF objectively. Multivariate logistic regression and restricted cubic spline analysis were conducted to investigate the association between SF and AF.</p><p><strong>Results: </strong>During a mean follow-up of 5.3 years, we observed 221 (9.30%) participants developed AF. Participants with incident AF had significantly worse WASO, arousal index, and sleep efficiency compared with those without incident AF. Multivariate logistic regression revealed that WASO was associated with incident AF in both overall sample and participants without obstructive sleep apnea, with odds ratios of 1.61 (95% confidence interval: 1.04, 2.49; <i>P</i> = .033) and 5.89 (95% confidence interval: 2.18, 19.16; <i>P</i> = .001) for the fourth quartile of WASO, respectively. The first quartile of sleep efficiency (odds ratio, 3.51; 95% confidence interval: 1.28, 10.49; <i>P</i> = .019) and the fourth quartile of arousal index (odds ratio, 3.16; 95% confidence interval: 1.23, 9.01; <i>P</i> = .021) were associated with incident AF in participants without obstructive sleep apnea.</p><p><strong>Conclusions: </strong>This study demonstrated that worsening SF, as assessed by WASO, sleep efficiency, and arousal index, was associated with an increased odds of incident AF in participants without obstructive sleep apnea. Thus, improving SF may contribute to decreasing the odds of incident AF.</p><p><strong>Citation: </strong>Wang L, Hui X, Huang R, Xiao Y. The association between sleep fragmentation and incident atrial fibrillation: a prospective cohort study in a community population. <i>J Clin Sleep Med</i>. 2025;21(7):1191-1200.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1191-1200"},"PeriodicalIF":2.9000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225268/pdf/","citationCount":"0","resultStr":"{\"title\":\"The association between sleep fragmentation and incident atrial fibrillation: a prospective cohort study in a community population.\",\"authors\":\"Lixia Wang, Xinjie Hui, Rong Huang, Yi Xiao\",\"doi\":\"10.5664/jcsm.11614\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study objectives: </strong>Sleep fragmentation (SF) has been recognized as a risk factor for cardiovascular disease. This study aims to investigate the impact of SF on atrial fibrillation (AF).</p><p><strong>Methods: </strong>A total of 2,377 participants without pre-existing AF from the Sleep Heart Health Study were enrolled in this study. Wake after sleep onset (WASO), SF index, arousal index, and sleep efficiency were used to describe SF objectively. Multivariate logistic regression and restricted cubic spline analysis were conducted to investigate the association between SF and AF.</p><p><strong>Results: </strong>During a mean follow-up of 5.3 years, we observed 221 (9.30%) participants developed AF. Participants with incident AF had significantly worse WASO, arousal index, and sleep efficiency compared with those without incident AF. Multivariate logistic regression revealed that WASO was associated with incident AF in both overall sample and participants without obstructive sleep apnea, with odds ratios of 1.61 (95% confidence interval: 1.04, 2.49; <i>P</i> = .033) and 5.89 (95% confidence interval: 2.18, 19.16; <i>P</i> = .001) for the fourth quartile of WASO, respectively. The first quartile of sleep efficiency (odds ratio, 3.51; 95% confidence interval: 1.28, 10.49; <i>P</i> = .019) and the fourth quartile of arousal index (odds ratio, 3.16; 95% confidence interval: 1.23, 9.01; <i>P</i> = .021) were associated with incident AF in participants without obstructive sleep apnea.</p><p><strong>Conclusions: </strong>This study demonstrated that worsening SF, as assessed by WASO, sleep efficiency, and arousal index, was associated with an increased odds of incident AF in participants without obstructive sleep apnea. Thus, improving SF may contribute to decreasing the odds of incident AF.</p><p><strong>Citation: </strong>Wang L, Hui X, Huang R, Xiao Y. The association between sleep fragmentation and incident atrial fibrillation: a prospective cohort study in a community population. <i>J Clin Sleep Med</i>. 2025;21(7):1191-1200.</p>\",\"PeriodicalId\":50233,\"journal\":{\"name\":\"Journal of Clinical Sleep Medicine\",\"volume\":\" \",\"pages\":\"1191-1200\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225268/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Sleep Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5664/jcsm.11614\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Sleep Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5664/jcsm.11614","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
The association between sleep fragmentation and incident atrial fibrillation: a prospective cohort study in a community population.
Study objectives: Sleep fragmentation (SF) has been recognized as a risk factor for cardiovascular disease. This study aims to investigate the impact of SF on atrial fibrillation (AF).
Methods: A total of 2,377 participants without pre-existing AF from the Sleep Heart Health Study were enrolled in this study. Wake after sleep onset (WASO), SF index, arousal index, and sleep efficiency were used to describe SF objectively. Multivariate logistic regression and restricted cubic spline analysis were conducted to investigate the association between SF and AF.
Results: During a mean follow-up of 5.3 years, we observed 221 (9.30%) participants developed AF. Participants with incident AF had significantly worse WASO, arousal index, and sleep efficiency compared with those without incident AF. Multivariate logistic regression revealed that WASO was associated with incident AF in both overall sample and participants without obstructive sleep apnea, with odds ratios of 1.61 (95% confidence interval: 1.04, 2.49; P = .033) and 5.89 (95% confidence interval: 2.18, 19.16; P = .001) for the fourth quartile of WASO, respectively. The first quartile of sleep efficiency (odds ratio, 3.51; 95% confidence interval: 1.28, 10.49; P = .019) and the fourth quartile of arousal index (odds ratio, 3.16; 95% confidence interval: 1.23, 9.01; P = .021) were associated with incident AF in participants without obstructive sleep apnea.
Conclusions: This study demonstrated that worsening SF, as assessed by WASO, sleep efficiency, and arousal index, was associated with an increased odds of incident AF in participants without obstructive sleep apnea. Thus, improving SF may contribute to decreasing the odds of incident AF.
Citation: Wang L, Hui X, Huang R, Xiao Y. The association between sleep fragmentation and incident atrial fibrillation: a prospective cohort study in a community population. J Clin Sleep Med. 2025;21(7):1191-1200.
期刊介绍：
Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.
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