Abstract Body (Do not enter title and authors here): Background
Sleep disorders are associated with an increased risk of atrial fibrillation (AF) due to shared risk factors. Despite this association, the sociodemographic mortality trends of these two conditions remain unstudied. This study explores the contemporary mortality trends in American adults (≥25 years) with coexisting AF and sleep disorders from 2000 to 2019.

Methods
We analyzed the mortality data using the CDC WONDER database, extracting age-adjusted mortality rates (AAMR) per 100,000 population from 2000 to 2019. AF was identified using ICD-10 code I48, and sleep disorders were identified using ICD-10 code G47. We included those mortalities in our analysis where both AF and sleep disorders were either the underlying or contributing cause of death. Trends were analyzed by year, sex, race and ethnicity, census region, and metropolitan status. We used the Jointpoint regression to calculate the annual percent change (APC) in AAMR with 95% confidence intervals.

Results
During the study period, a total of 27,516 deaths occurred in patients where both AF and sleep disorders were listed as contributing to death, with an overall AAMR of 0.62 per 100,000. The overall AAMR increased from 0.08 in 2000 to 1.55 in 2019, with a significantly increasing trend from 2000 to 2009 (APC: 18.89, p < 0.001) and from 2009 to 2019 (APC: 13.30, p < 0.001). Men had a higher AAMR (0.99) than women (0.39). White population had the highest AAMR (0.70), followed by American Indians or Alaska Natives (0.63), Blacks or African Americans (0.46), Hispanics or Latinos (0.25), and Asians or Pacific Islanders (0.16). Significant geographic variation was observed, with the Midwest region (0.80) exhibiting the highest AAMR. Non-metropolitan areas had a higher AAMR (0.75) than metropolitan areas (0.58).

Conclusion
The mortality trend related to coexisting AF and sleep disorders constantly rose throughout the study period, with important sociodemographic disparities. Further research is warranted to address the mortality secondary to coexisting AF and sleep disorders.