Final_article_PLMS_prevalence_AF_IJC_2017.pdf

Background: Growing evidence indicates that periodic limb movements of sleep (PLMS) may be related to increased

risk 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 investigatewhether

PLMS were associated with increased AF prevalence, independent of established risk factors.

Methods: We performed a cross-sectional study of patients who underwent attended polysomnography atMayo

Clinic from2011 to 2014. The association of PLMSwith AF prevalence was estimated by using logistic regression

models.

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 periodic

limb 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 (for

age, race, sex, history of smoking, hypertension, diabetes, coronary artery disease, heart failure, cerebrovascular

disease, renal disease, iron deficiency anemia, chronic obstructive pulmonary disease, AHI, arousal

index), inmild SDB patients, a PLMI ≥30/h or periodic limbmovement arousal index (PLMAI) ≥5/h had significantly

higher 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. Further

studies are needed to better understand the relationship with incident AF.