Self-Reported Sleep Quality of Patients with Atrial Fibrillation and the Effects of Cardioversion on Sleep Quality

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dc.contributor.authorKayrak, Mehmet
dc.contributor.authorGul, Enes Elvin
dc.contributor.authorAribas, Alpay
dc.contributor.authorAkilli, Hakan
dc.contributor.authorAlibasic, Hajrudin
dc.contributor.authorAbdulhalikov, Turyan
dc.contributor.authorYildirim, Oguzhan
dc.date.accessioned2024-02-23T14:24:33Z
dc.date.available2024-02-23T14:24:33Z
dc.date.issued2013
dc.departmentNEÜen_US
dc.description.abstractBackground Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance encountered in clinical practice and is associated with impaired quality of life. Data from the previous studies have shown that sleep quality (SQ), as a component of life quality, may also deteriorate in patients with AF. However, it remains unclear; we do not know whether SQ improves after sinus rhythm is maintained. Therefore, we aimed to examine the relationship between SQ and AF, as well as the effects of sinus rhythm restoration with direct current cardioversion (DCC) on SQ among patients with persistent AF. Methods One hundred fifty-three patients with a diagnosis of nonvalvular AF and 150 age-matched control subjects with sinus rhythm were recruited. SQ was assessed using the Pittsburgh Sleep Quality Index (PSQI). The study was designed with two stages. First, the difference in SQ between AF patients and age-matched controls was examined. Patients with global PSQI scores greater than 5 were defined as poor sleepers. Thus, a higher global PSQI score indicated worsened SQ. Predictors of poor SQ were also analyzed using a regression model. Second, the effect of rhythm control on SQ was studied in patients with AF who were eligible for DCC. Of the 65 patients with persistent AF, 54 patients with successful cardioversion were followed for 6 months. The remaining 11 patients, whose cardioversion was unsuccessful, were not followed. After 6 months of follow-up, the PSQI scores of patients with sinus rhythm maintenance (n = 39) and patients with AF recurrence (n = 15) were reassessed. Changes in global PSQI scores (baseline vs after 6 months) were analyzed. Results The PSQI scores were significantly higher in the AF group compared to the control group (9.4 +/- 4.6 vs 5.8 +/- 4.1, P = 0.001, respectively). The prevalence of poor sleepers was significantly higher in the AF group (76%) than in the control group (45%) (P < 0.001 by the (2) test). Multivariate logistic regression analysis showed that AF (odds ratio [OR]: 3.36, 95% confidence interval [CI]: 2.00-5.55), age (OR: 1.02, 95% CI: 1.00-1.04), and diabetes mellitus (OR:1.79, 95% CI: 1.03-3.14) were independent predictors of poor SQ. In the second stage, the effect of rhythm control on the SQ of the 54 patients with successful DCC was analyzed. PSQI scores improved significantly between baseline and the 6 months in sinus rhythm maintenance group (8.7 +/- 4.1 vs 7.2 +/- 3.8, P < 0.001, respectively). However, in the AF recurrence group, the change in global PSQI scores between baseline and the sixth month was not statistically significant (9.8 +/- 4.5 vs 9.2 +/- 4.2, P = 0.56, respectively). Conclusion Patients with AF have shorter sleep duration and poor SQ. Maintenance of sinus rhythm after DCC may have a favorable effect on the SQ of patients with AF. Nevertheless, AF is an independent predictor of poor SQ.en_US
dc.identifier.doi10.1111/pace.12115
dc.identifier.endpage829en_US
dc.identifier.issn0147-8389
dc.identifier.issn1540-8159
dc.identifier.issue7en_US
dc.identifier.pmid23437796en_US
dc.identifier.scopus2-s2.0-84879687848en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage823en_US
dc.identifier.urihttps://doi.org/10.1111/pace.12115
dc.identifier.urihttps://hdl.handle.net/20.500.12452/14005
dc.identifier.volume36en_US
dc.identifier.wosWOS:000321185400006en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofPace-Pacing And Clinical Electrophysiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAtrial Fibrillationen_US
dc.subjectSleep Qualityen_US
dc.subjectPittsburgh Sleep Quality Indexen_US
dc.subjectElectrical Cardioversionen_US
dc.titleSelf-Reported Sleep Quality of Patients with Atrial Fibrillation and the Effects of Cardioversion on Sleep Qualityen_US
dc.typeArticleen_US

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