Table 2.

Summary of studies investigating risk of atrial fibrillation in central sleep apnea.

Investigator	Population	Methods of diagnosis for CSA	Results
Sin et al. (1999)	N = 450 Patient with CHF	PSG	Patients with CSA were older and had a higher prevalence of AF compared to those with OSA or no SDB (P < 0.05). AF is an independent risk factor for CSA but not for OSA. (OR 4.13; 95% CI 1.53 to 11.14)
Leung et al. (2005)	N = 67 Patients with idiopathic CSA	PSG	The prevalence of AF in patients with idiopathic CSA (27%) was 16-fold higher than in the OSA group (1.7%) and 8-fold higher than in the no-SDB group (3.3%). (P < 0.001).
Oldenburg et al (2007)	N = 700 Stable patients with NYHA class ≥ II and impaired LVEF ≤ 40%	Cardiorespiratory polygraphy (Embletta, Medcare, Island)	The severity of of SDB was significantly worse in CSA patients than OSA patients based on AHI (30.2/h vs. 18.5/h) The prevalence of AF was higher in CSA (35%) than in OSA (21%) and no SDB (14%).
Schulz et al. (2007)	N = 203	1). Stardust II system: for polygraphy 2) Pressure cannula3)Plethysmographic belt	AF and lower PCO2 was more often seen in patients with CSR.
Mehra et al. (2009)	N = 2911 Older men	PSG	Increasing SDB severity defined by RDI quartile in unadjusted analyses noted an increasing percentage of AF. CSA was more strongly associated with AF (OR: 2.69; 95%CI, 1.61–4.47)
Grimm et al. (2015)	N = 267 Patient with LVEF ≤ 50%	PSG	Multivariate analysis revealed a significant association between AF and severe CSA (odds ratio [OR]: 5.21; 95% confidence interval [CI]: 1.67–16.27, P = 0.01)
May et al. (2016)	N = 843 Older men without prevalent AF	PSG	Central sleep apnea (odds ratio [OR], 2.58; 95%CI, 1.18–5.66) and CSR with CSA (OR, 2.27; 95% CI, 1.13–4.56), but not OSA or hypoxemia, predicted Incidence of AF.
Tung et al. (2017)	N = 2912 Patients without a history of AF in the SHHS	PSG	CSA was a predictor of incident AF in all adjusted models and associated with a 2- to 3-fold increased odds of developing AF (central apnea index ≥ 5 odds ratio [OR], 3.00, 1.40–6.44; Cheyne–Stokes respiration OR, 1.83, 0.95–3.54; CSA or Cheyne–Stokes respiration OR, 2.00, 1.16–3.44).

CHF = congestive heart failure; PSG = polysomnography; CSA = central sleep apnea; OSA = obstructive sleep apnea; AF = atrial fibrillation; SDB = sleep-disordered breathing; OR = odds ratio; CI = confidence interval; NYHA = New York Heart Association; LVEF = left ventricular ejection fraction; AHI: Apnea hypopnea index; CSR = Cheyne-Stokes respiration; RDI = Respiratory disturbance index; SHHS = Sleep Heart Health Study.