Obstructive sleep apnea (OSA) promotes the development of cardiovascular diseases. Studying the relationship between sleep apnea and atrial fibrillation (AF) is relevant.

OBJECTIVE

To analyze the obstructive sleep apnea relation to paroxysmal atrial fibrillation in post-menopausal women with ischemic heart disease and hypertension.

MATERIALS AND METHODS

We examined 123 post-menopausal women with chronic ischemic heart disease and stage II-III, grade 1—2 hypertension with high or very high risk. Group I included 88 patients with paroxysmal AF, Group II — 35 patients without paroxysmal AF. The study was conducted at Smolensk Regional Clinical Hospital in 2021—2022 using the SomnoCheck micro device (Weinmann, Germany) for respiratory monitoring. Normal apnea-hypopnea index (AHI) is <5 events per hour. Mild OSA severity corresponds to an AHI of at least five events per hour but fewer than 15; an AHI of at least 30 events per hour indicates severe OSA. The patients were questioned using the NoSAS scale. A score of ≥8 indicated a high probability of OSA.

RESULTS

OSA was detected in 57.9% of women in Group I, by 20.8% more often than in Group II (χ²=4.35; p=0.038). AHI ≥15 events per hour was reported in 26.1% of patients in Group I, by 17.5% more often than in Group II (p<0.05 by two-tailed Fisher test). In Group I, 91.3% of women scored ≥8 on the NoSAS scale; the average score was 11 (9; 15) points. Patients with AF had statistically significantly higher AHI values (16.2 events/h), desaturation index (10.6 events/h), and lower min SpO₂ (82.3%) compared to women without arrhythmia (9.1 events/h, 5.4 events/h, and 86.9%, respectively).

CONCLUSION

In the study, 91.3% of patients with ischemic heart disease, hypertension, and paroxysmal atrial fibrillation had a high probability of having sleep apnea, according to the NoSAS scale. Obstructive sleep apnea was associated with paroxysmal atrial fibrillation in post-menopausal women with ischemic heart disease and hypertension (3.77 times higher with an apnea-hypopnea index of ≥15 events per hour).