{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:30:05Z","timestamp":1791203405677,"version":"4.2.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100018918","name":"MicroPort","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018918","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Using pacemaker\u2010derived thoracic impedance monitoring, sleep apnea severity and its night\u2010to\u2010night variability can be continuously tracked in patients with implanted cardiac devices. In the prospective ACaSA study, 171 pacemaker patients without permanent atrial fibrillation at baseline were followed for a median of 539\u2009days. During an initial 28\u2010night run\u2010in period free of atrial fibrillation, baseline night\u2010to\u2010night variability of the respiratory disturbance index (RDI) was quantified as the coefficient of variation. Patients were subsequently monitored for the onset of persistent device\u2010detected atrial fibrillation (DDAF, \u2265\u20097\u2009days) and cumulative DDAF burden. Median RDI variability was 38.7% (IQR 29.9%\u201347.6%), and 35 patients (20.5%) had high variability (\u2265\u200950%). Over follow\u2010up, 17 patients (9.9%) developed persistent DDAF. Each 10% increase in RDI variability was associated with a significantly higher risk of persistent DDAF (adjusted HR 1.89, 95% CI 1.26\u20132.84;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002). Patients with high variability also carried a greater cumulative DDAF burden compared to those with low variability (9.6% vs. 1.9%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016). These results suggest that the dynamic instability of sleep apnea, reflected by night\u2010to\u2010night variability, is associated with DDAF persistence and burden. Continuous long\u2010term monitoring through pacemaker systems offers a novel approach for risk stratification and may open opportunities for more personalised management strategies.\n                  <\/jats:p>","DOI":"10.1111\/jsr.70313","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:46:38Z","timestamp":1772988398000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Night\u2010To\u2010Night Variability in Sleep Apnea Is Associated With Persistence and Burden of Device\u2010Detected Atrial Fibrillation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5908-2923","authenticated-orcid":false,"given":"Philipp","family":"Spitaler","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Bilgeri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Rockenschaub","sequence":"additional","affiliation":[{"name":"Institute of Clinical Epidemiology, Public Health, Health Economics, Medical Statistics and Informatics Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"},{"name":"Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charit\u00e9  Berlin Germany"},{"name":"Institute of Active Polymers and Berlin\u2010Brandenburg Center for Regenerative Therapies Helmholtz\u2010Zentrum Hereon  Teltow Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birkan","family":"Tugrul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agne","family":"Adukauskaite","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"St\u00fchlinger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard 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