Final_article_PLMS_prevalence_AF_IJC_2017.pdf

Background: Growing evidence indicates that periodic limb movements of sleep (PLMS) may be related to increasedrisk of developing cardiovascular disease. However, the association of PLMS with atrial fibrillation (AF)is unclear, especially in patientswith sleep-disordered breathing (SDB). This study sought to investigatewhetherPLMS were associated with increased AF prevalence, independent of established risk factors.Methods: We performed a cross-sectional study of patients who underwent attended polysomnography atMayoClinic from2011 to 2014. The association of PLMSwith AF prevalence was estimated by using logistic regressionmodels.Results: 15,414 patients were studied, 76.3% of individuals with SDB defined by apnea-hypopnea index(AHI) ≥5/h, and 15.3% with a diagnosis of AF. In univariate logistic modelling, individuals with periodiclimb movement index (PLMI) ≥30/h had higher odds of AF (odds ratio [OR] 1.96, 95% confidence interval[CI]1.79–2.16, p b 0.001) when compared to patients with PLMI b15/h. After multivariate adjustment (forage, race, sex, history of smoking, hypertension, diabetes, coronary artery disease, heart failure, cerebrovasculardisease, renal disease, iron deficiency anemia, chronic obstructive pulmonary disease, AHI, arousalindex), inmild SDB patients, a PLMI ≥30/h or periodic limbmovement arousal index (PLMAI) ≥5/h had significantlyhigher odds of AF than thosewith PLMI b15/h (OR 1.21, 95% CI 1.00–1.47, p=0.048) or PLMAI b1/h (OR 1.27, 95%CI 1.03–1.56, p= 0.024).Conclusions: Frequent PLMS are independently associated with AF prevalence in patients with mild SDB. Furtherstudies are needed to better understand the relationship with incident AF.