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