{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:52:38Z","timestamp":1791971558741,"version":"4.3.4"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias worldwide. This study aimed to evaluate the association between sleep\u2010disordered breathing (SDB), primarily assessed using the apnea\u2013hypopnea index (AHI), and AF risk, with additional analysis of sleep fragmentation parameters such as wake after sleep onset (WASO) and arousal index (AI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis followed Cochrane Handbook recommendations and PRISMA guidelines, with protocol registration in PROSPERO (No. 127490). Randomized controlled trials (RCTs) and observational cohort studies assessing sleep disturbances and AF were included. MEDLINE, Cochrane Library, and Scopus were searched from inception to February 2026. Extracted data included study characteristics, demographics, cardiovascular risk factors, and sleep metrics. Outcomes were incident and recurrent AF. A random\u2010effects model was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010one cohort studies (611,898 participants) were included. SDB was associated with increased incident AF risk (RR 1.67, 95% CI 1.41\u20131.97;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200966.5%), with consistent Bayesian estimates. A dose\u2013response relationship showed a 2% increase in AF risk per unit rise in AHI. For AF recurrence, 11 studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091810) demonstrated a significant association (RR 1.55, 95% CI 1.40\u20131.72;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), supported by Bayesian analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sleep disturbances are significantly associated with both incident and recurrent AF and may represent modifiable risk factors.<\/jats:p>\n                  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