Abstract Body:
Background: Sleep disturbances are prevalent among individuals with excess adiposity and may contribute to atrial abnormalities. However, the relationship between sleep and atrial cardiopathy remains unexplored. We hypothesized that poor sleep quality and shorter sleep duration would be associated with prevalent atrial cardiopathy in adults with overweight or obesity.
Methods: This cross-sectional analysis included participants from the Long-term Effectiveness of the Anti-Obesity medication Phentermine (LEAP) trial with sleep and electrocardiogram (ECG) data at baseline. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). Global scores were used to categorize individuals as having poor (>5) or good (≤5) quality sleep; self-reported sleep duration was categorized as short (<7 h/night) or sufficient (≥7 h/night). Atrial cardiopathy (present vs. absent) was defined from ECG as P-wave terminal force in lead V1 >4000 , P-wave duration >120 ms, P-wave axis (<0 ° or <75 °), or presence of premature atrial contractions. Multivariable logistic regression models examined the associations of sleep quality and duration with atrial cardiopathy, adjusting for sociodemographics and cardiometabolic risk factors. Effect modification by body mass index (BMI) was also evaluated.
Results: Among 851 participants (mean age 49±12 years, 72% female, 60.5% white, mean BMI 35.7±4.3 kg/m2),209 participants (24.6%) met criteria for atrial cardiopathy. Poor sleep quality was reported in 452 (53%) of participants. In multivariable-adjusted models, neither poor sleep quality or short sleep duration was associated with atrial cardiopathy ((ORs with 95% confidence interval: 0.85, (0.61-1.2) and 1.13, (0.81-1.58)), respectively. The associations of sleep disturbance (poor quality, short duration) with atrial cardiopathy were similar across BMI strata defined by median BMI, with no significant effect modification observed (all interaction p-values >0.8).
Conclusions: In adults with overweight and obesity, our results revealed that poor sleep quality and short sleep duration were not associated with atrial cardiopathy. It is possible that both sleep quality and atrial remodeling have already been altered in this patient population. Future studies including individuals without overweight or obesity may help clarify whether sleep disturbances are independently associated with atrial cardiopathy.