Association of Atrial Fibrillation with Insomnia in the Elderly Population

Abstract

Introduction/Objectives: Insomnia is a common sleep disorders that affects most individuals in the United States, and worldwide. Insomnia is linked with an increased risk of atrial fibrillation (AF) in adults, although the strengths of association were weak, especially in the elderly population. AF is estimated to affect approximately 3 to 6 million people in the United States. We studied the association of AF with insomnia in the elderly population. Methods: We reviewed the electronic medical records of elderly patients who received care in an internal medicine office from July 1, 2020 through June 30, 2021. Patients were grouped into AF group, and a group without AF (NOAF). Association of insomnia and other variables were compared between the 2 groups. Results: Among 2428 patients, 341 (14%) had AF. Patients in the AF group were significantly older compared to no-AF group (80.3 ± 7.9 vs 76.1 ± 7.4 years; P < .001). A higher frequency of men was noted in AF group versus NOAF group (54.3 vs 42.0%; P < .001). The frequency of insomnia was significantly higher in AF group versus NOAF group (14.1 vs 9.5%; P < .05). Additionally, greater frequencies of associations of other comorbid medical conditions were noted in the AF group compared to NOAF group, such as cerebrovascular accident (CVA; 12.9 vs 5.4%; P < .001), transient ischemic attack (TIA; 7.0 vs 3.0%; P < .001), dementia (5.9 vs 3.3%; P < .05), coronary artery disease (CAD; 34.9 vs 18.3%; P < .001), congestive heart failure (CHF; 21.1 vs 3.8%; P < .001), other cardiac arrhythmias (53.4 vs 6.3%; P < .001), chronic obstructive pulmonary disease (COPD; 12.3 vs 5.7%; P < .001), obstructive sleep apnea (OSA; 17.6 vs 11.8%; P = .003), chronic kidney disease (CKD; 22.9 vs 11.9%; P < .001), anemia (23.2 vs 13.0%; P < .001), and cancer (36.1 vs 27.9%; P = .002). There was significantly greater odds of AF in patients who had insomnia (OR = 1.972, CI = 1.360-2.851; P < .001). Conclusion: AF was associated with insomnia in the elderly population. Higher frequencies of association of AF were also seen with older age, male sex, White race, CVA, TIA, dementia, CAD, CHF, other cardiac arrhythmias, COPD, OSA, CKD, anemia, and cancer.