Investigation Of Atrial Fibrillation And Sleep Disorders And Analysis Of Related Risk Factors

Objective:(1)To explore the correlation between atrial fibrillation and sleep disorders.(2)To compare the relationship between the severity of atrial fibrillation and sleep disorders,in order to provide more comprehensive intervention and guidance to patients with atrial fibrillation and improve the quality of life of patients with atrial fibrillation.Methods:A total of 285 patients with non-valvular atrial fibrillation admitted to the Department of Cardiology of Shaanxi people’s Hospital from March 2019 to December 2020 were collected as atrial fibrillation group.215 patients with non-atrial fibrillation in the same period were selected as non-atrial fibrillation group.The general clinical data,sleep quality score,serological index and cardiac ultrasound results of all patients were collected.The Pittsburgh Sleep quality Index(PSQI)was used to investigate and evaluate the sleep status of all subjects in recent 1 month.The results showed that the higher the score,the worse the sleep status.The total score of PSQI≥7 was used as the reference cut-off value for the diagnosis of sleep disorder,that is,the total score of PSQI≥7 was judged as the patient with sleep disorder,otherwise it was judged as the patient without sleep disorder.The data were analyzed by SPSS25.0 statistical software.Descriptive statistical analysis,t-test,χ~2-test and related factors Logistic regression analysis were used to explore the relationship between atrial fibrillation and its severity and sleep disorders.Results:(1)Comparison of general clinical data between atrial fibrillation group and non-atrial fibrillation group:a total of 500 subjects were included in this study,285(57.0%)in atrial fibrillation group and 215(43.0%)in non-atrial fibrillation group.There was no significant difference in sex,age,smoking history,drinking history,hypertension history,diabetes history,coronary heart disease history and NYHA classification of cardiac function between the two groups(P>0.05).The PSQI score of atrial fibrillation group and non-atrial fibrillation group was 7.67±4.24vs7.12±3.40(P<0.001).The incidence of sleep disorder in atrial fibrillation group and non-atrial fibrillation group was50.18%vs38.14%(P<0.007).There were significant differences in PSQI score and the incidence of sleep disorders between atrial fibrillation group and non-atrial fibrillation group(P<0.05).(2)Comparison of laboratory indexes between atrial fibrillation group and non-atrial fibrillation group:there were no significant differences in left atrial diameter,left ventricular diameter and interventricular septum thickness,EF,BNP,K~+,UA,TBi L,TC,HDL-C between the two groups(P>0.05).The HCY in atrial fibrillation group and non-atrial fibrillation group was 12.41±2.92umol/Lvs11.84±1.80umol/L(P=0.013).The TG in atrial fibrillation group and non-atrial fibrillation group was 1.49±0.77mmol/Lvs1.69±0.86mmol/L(P=0.007).The LDL-C in atrial fibrillation group and non-atrial fibrillation group was 1.84±0.74mmol/Lvs1.64±0.96mmol/L(P=0.009).The TSH in atrial fibrillation group and non-atrial fibrillation group was 2.89±2.39u IU/mlvs6.02±2.66u IU/ml(P<0.001).The Hb A1c in atrial fibrillation group and non-atrial fibrillation group was 6.33±1.08%vs6.09±1.40%(P=0.035).There was significant difference in HCY,TG,LDL-C,TSH,Hb A1c between atrial fibrillation group and non-atrial fibrillation group(P<0.05).(3)Logistic regression Analysis of Atrial Fibrillation,Sleep Disorder and related factors:Logistic regression analysis showed that TG,TSH,Hb A1c and sleep disorders were independently correlated with the occurrence of atrial fibrillation after correcting the confounding factors(P<0.05).The levels of TG(OR=0.675)and TSH(OR=0.596)are the protective factors of atrial fibrillation,while the levels of Hb A1c(OR=1.255)and sleep disturbance(OR=1.872)are the risk factors of atrial fibrillation.(4)There was no significant difference in smoking history,drinking history,hypertension history,diabetes history and cardiac function grade between paroxysmal atrial fibrillation group(n=202)and persistent atrial fibrillation group(n=83)(P>0.05).The male of paroxysmal atrial fibrillation group and persistent atrial fibrillation group was49.50%vs43.73%(P=0.015).The age of paroxysmal atrial fibrillation group and persistent atrial fibrillation group was 54.20±13.56 years vs 69.88±10.86 years(P<0.001).The coronary heart disease history of paroxysmal atrial fibrillation group and persistent atrial fibrillation group was 51.49%vs37.35%(P=0.030).The PSQI score of paroxysmal atrial fibrillation group and persistent atrial fibrillation group was 6.79±2.88vs9.82±5.90(P<0.001).The incidence of sleep disorder in paroxysmal atrial fibrillation group and persistent atrial fibrillation group was 45.05%vs62.65%(P<0.007).There were significant differences in sex,age,history of coronary heart disease,PSQI score and the incidence of sleep disorders between paroxysmal atrial fibrillation group and persistent atrial fibrillation group(P<0.05).(5)There was no significant difference in left atrial diameter,left ventricular diameter and interventricular septum thickness,EF,BNP,K~+,UA,HCY,TBi L,TG,HDL-C,LDL-C,TSH,and Hb A1c between paroxysmal AF group and persistent AF group(P>0.05).The TC in paroxysmal atrial fibrillation group and persistent atrial fibrillation group was3.89±1.18mmol/Lvs4.27±1.78mmol/L(P=0.034),that is,there was significant differences in TC between the two groups(P<0.05).(6)Logistic regression analysis of atrial fibrillation types and sleep disorders and its influencing factors:Logistic regression analysis showed that after adjusting for confounding factors,male,age and sleep disorder were independently correlated with persistent atrial fibrillation(P<0.05).Male(OR=0.539)is the protective factor of persistent atrial fibrillation,age(OR=1.055)and sleep disturbance(OR=1.906)are risk factors of persistent atrial fibrillation.Conclusion:(1)There is a positive correlation between sleep disorders and the occurrence of atrial fibrillation,suggesting that sleep disorders may increase the risk of atrial fibrillation to some extent.(2)There is a positive correlation between sleep disorders and persistent atrial fibrillation.It is suggested that sleep disorders may affect the severity of atrial fibrillation.