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Prevalence and Diagnosis of Obstructive Sleep Apnea in Atrial Fibrillation Patients

2025-08Recensão Acesso aberto
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dc.contributor.authorSousa, Susana
dc.contributor.authorDrummond, Marta
dc.contributor.authorBugalho, António
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblMDPI - Multidisciplinary Digital Publishing Institute
dc.date.accessioned2025-09-16T21:48:21Z
dc.date.available2025-09-16T21:48:21Z
dc.date.issued2025-08
dc.descriptionFunding Information: This research was funded by a grant from Jos\u00E9 de Mello Sa\u00FAde. Publisher Copyright: © 2025 by the authors.
dc.description.abstractObstructive sleep apnea (OSA) is a highly prevalent and underdiagnosed sleep disorder with significant cardiovascular implications, namely in atrial fibrillation (AF) patients. Despite its clinical relevance, OSA prevalence among AF patients and the diagnostic strategies used remain heterogeneous across studies, complicating screening, and treatment pathways. Our aim was to synthesize recent evidence on OSA prevalence in AF populations and to critically evaluate the diagnostic methods and screening strategies employed in clinical studies, by conducting a systematic review using PubMed and Google Scholar to identify original clinical studies published between January-2019 and December-2024. Inclusion criteria targeted adult AF populations assessed for OSA or sleep-disordered breathing. The results were analyzed by two independent reviewers. Non-concordances were resolved by consensus. Data extracted included study characteristics, population profiles, diagnostic approaches, prevalence rates, symptom profiles, and clinical correlates. Thirty-eight studies were included, comprising predominantly observational studies. Prevalence estimates of OSA in AF populations ranged from 5% to 90%, with most studies reporting rates > 60%. A consistent burden of moderate-to-severe OSA was observed. Diagnostic methods varied widely, from polysomnography (PSG) and home sleep apnea testing to pacemaker-derived monitoring and questionnaires such as STOP-Bang and Epworth Sleepiness Scale (ESS). Underdiagnosis was attributed to minimal symptomatology, lack of physician awareness, and reliance on subjective tools. Several studies highlighted the limited sensitivity of standard screening instruments in AF populations and advocated for objective testing even in asymptomatic patients. Marked heterogeneity in study designs, diagnostic methods, and populations precluded quantitative synthesis and limited direct comparisons. Objective diagnostic testing, particularly PSG, is essential to improve OSA detection rates and guide individualized management. Integration of structured screening protocols into AF care—especially for high-risk patients—and interdisciplinary collaboration are critical.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent748820
dc.identifier.doi10.3390/jcm14165708
dc.identifier.issn2077-0383
dc.identifier.otherPURE: 129420835
dc.identifier.otherPURE UUID: b13d4785-f5a1-49a7-9ca3-3c13ea79d94e
dc.identifier.otherScopus: 105014345735
dc.identifier.urihttp://hdl.handle.net/10362/187983
dc.identifier.urlhttps://www.scopus.com/pages/publications/105014345735
dc.language.isoeng
dc.peerreviewedyes
dc.subjectatrial fibrillation
dc.subjectcardiac arrhythmias
dc.subjectcardiovascular comorbidity
dc.subjectcardiovascular disease
dc.subjectdiagnosis
dc.subjecthome sleep apnea testing
dc.subjectobstructive sleep apnea
dc.subjectpolysomnography
dc.subjectprevalence
dc.subjectrisk factors
dc.subjectsleep-disordered breathing
dc.subjectsystematic review
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titlePrevalence and Diagnosis of Obstructive Sleep Apnea in Atrial Fibrillation Patientsen
dc.title.subtitleA Systematic Reviewen
dc.typereview
degois.publication.issue16
degois.publication.titleJournal of Clinical Medicine
degois.publication.volume14
dspace.entity.typePublication
rcaap.rightsopenAccess

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