{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T11:24:13Z","timestamp":1793532253016,"version":"4.5.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,7]]},"abstract":"\n Background<\/jats:title>\n \n Previous studies have documented a high prevalence of atrial fibrillation (\n AF<\/jats:styled-content>\n ) in individuals with obstructive sleep apnea (\n OSA<\/jats:styled-content>\n ). Central sleep apnea (\n CSA<\/jats:styled-content>\n ) has been associated with\n AF<\/jats:styled-content>\n in patients with heart failure. However, data from prospective cohorts are sparse and few studies have distinguished the associations of obstructive sleep apnea from\n CSA<\/jats:styled-content>\n with\n AF<\/jats:styled-content>\n in population studies.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We assessed the association of obstructive sleep apnea and\n CSA<\/jats:styled-content>\n with incident\n AF<\/jats:styled-content>\n among 2912 individuals without a history of\n AF<\/jats:styled-content>\n in the SHHS (Sleep Heart Health Study), a prospective, community\u2010based study of existing (\u201cparent\u201d) cohort studies designed to evaluate the cardiovascular consequences of sleep disordered breathing. Incident\n AF<\/jats:styled-content>\n was documented by 12\u2010lead\n ECG<\/jats:styled-content>\n or assessed by the parent cohort. obstructive sleep apnea was defined by the obstructive apnea\u2010hypopnea index (\n OAHI<\/jats:styled-content>\n ).\n CSA<\/jats:styled-content>\n was defined by a central apnea index \u22655 or the presence of Cheyne Stokes Respiration. Logistic regression was used to assess the association between sleep disordered breathing and incident\n AF<\/jats:styled-content>\n . Over a mean of 5.3\u00a0years of follow\u2010up, 338 cases of incident\n AF<\/jats:styled-content>\n were observed.\n CSA<\/jats:styled-content>\n was a predictor of incident\n AF<\/jats:styled-content>\n in all adjusted models and was associated with 2\u2010 to 3\u2010fold increased odds of developing\n AF<\/jats:styled-content>\n (central apnea index \u22655 odds ratio [\n OR],<\/jats:styled-content>\n 3.00, 1.40\u20136.44; Cheyne\u2013Stokes respiration\n OR,<\/jats:styled-content>\n 1.83, 0.95\u20133.54;\n CSA<\/jats:styled-content>\n or Cheyne\u2013Stokes respiration\n OR,<\/jats:styled-content>\n 2.00, 1.16\u20133.44). In contrast,\n OAHI<\/jats:styled-content>\n was not associated with incident\n AF<\/jats:styled-content>\n (\n OAHI<\/jats:styled-content>\n per 5\u00a0unit increase\n OR,<\/jats:styled-content>\n 0.97, 0.91\u20131.03;\n OAHI<\/jats:styled-content>\n 5 to <15\n OR,<\/jats:styled-content>\n 0.84, 0.59\u20131.17;\n OAHI<\/jats:styled-content>\n 15 to <30\n OR,<\/jats:styled-content>\n 0.93, 0.60\u20131.45;\n OAHI<\/jats:styled-content>\n \u226530\n OR,<\/jats:styled-content>\n 0.76, 0.42\u20131.36).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In a prospective, community\u2010based cohort,\n CSA<\/jats:styled-content>\n was associated with incident\n AF<\/jats:styled-content>\n , even after adjustment for cardiovascular risk factors.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004500","type":"journal-article","created":{"date-parts":[[2017,7,2]],"date-time":"2017-07-02T00:10:11Z","timestamp":1498954211000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":114,"title":["Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women"],"prefix":"10.1161","volume":"6","author":[{"given":"Patricia","family":"Tung","sequence":"first","affiliation":[{"name":"Division of Cardiology, Atrius Health, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamini S.","family":"Levitzky","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Newton\u2010Wellesley Hospital, Newton, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Weng","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart F.","family":"Quan","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MA"},{"name":"Arizona Respiratory Center, University of Arizona, Tucson, AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MA"},{"name":"VA Boston Healthcare System, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rueschman","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh M.","family":"Punjabi","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena","family":"Mehra","sequence":"additional","affiliation":[{"name":"Sleep Center, Neurologic Institute, Cleveland Clinic, Cleveland, OH"},{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzie","family":"Bertisch","sequence":"additional","affiliation":[{"name":"Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emelia J.","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, MA"},{"name":"Boston University School of Public Health, Boston, MA"},{"name":"NHLBI's and Boston University's Framingham Heart Study, Framingham, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Harvard Medical School, Boston, MA"},{"name":"Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000140263.20897.42"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.962688"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200509-1442OC"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00019501-199606000-00011"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.081257"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.03.052"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.080"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-010-9502-8"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000068337.25994.21"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115184"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(91)90005-W"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112813"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115757"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112141"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0160-4120(89)90067-6"},{"key":"e_1_3_4_18_2","first-page":"S66","article-title":"Can behavioural factors produce a sustained elevation of blood pressure? Some observations and a hypothesis","volume":"9","author":"Pickering TG","year":"1991","unstructured":"Pickering TG, Schnall PL, Schwartz JE, Pieper CF. Can behavioural factors produce a sustained elevation of blood pressure? Some observations and a hypothesis. J Hypertens Suppl. 1991;9:S66\u2013S68.","journal-title":"J Hypertens Suppl"},{"key":"e_1_3_4_19_2","first-page":"1077","article-title":"The Sleep Heart Health Study: design, rationale, and methods","volume":"20","author":"Quan SF","year":"1997","unstructured":"Quan SF, Howard BV, Iber C, Kiley JP, Nieto FJ, O'Connor GT, Rapoport DM, Redline S, Robbins J, Samet JM, Wahl PW. The Sleep Heart Health Study: design, rationale, and methods. Sleep. 1997;20:1077\u20131085.","journal-title":"Sleep"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/21.7.759"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/21.7.749"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/22.5.667"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.05.010"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.7.2455"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000138154.00779.A5"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.000102"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.14.1829"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(84)80433-7"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.160.4.9903020"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/28.12.1543"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.138"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.125.3.879"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201508-1523OC"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.6.7952621"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.152.2.7633695"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.114.303772"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.09.030"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2203016"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2110041"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909233411304"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.11010007"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.03.020"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.08.060"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001273420416"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.03.053"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.2.422"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.4.1085"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.7.2007014"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00218211"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000049641.11675.EE"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000136587.68725.8E"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.901801"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.004500","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:31:27Z","timestamp":1715596287000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.004500"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":51,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1161\/JAHA.116.004500"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.004500","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"assertion":[{"value":"2016-08-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004500"}}