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Background <p>Sleep disorders are common yet underexamined in relation to cardiac arrhythmias. We systematically reviewed sex-specific associations between insomnia and restless legs syndrome and arrhythmias, focusing on atrial fibrillation.</p> Methods <p>Following a registered protocol (PROSPERO: CRD420251134871), we searched Pubmed(Medline) and performed reference/citation tracking (2015–2025; English). Eligible designs were observational (cohort, case–control, cross-sectional) reporting arrhythmia outcomes and sex-specific data or enabling sex-stratified extraction. Two reviewers screened, extracted data, and assessed risk of bias with ROBINS-E.</p> Results <p>Of 127 records, 4 studies met criteria. Insomnia was consistently associated with increased risk of atrial fibrillation (AF) and other arrhythmias across observational studies. Individuals with frequent insomnia had up to a twofold higher AF risk, with elevated vascular resistance observed in restless legs syndrome (RLS). Prospective data showed poor sleep patterns predicted AF incidence, particularly among women. Sex-stratified analyses suggested greater vulnerability to sleep-related arrhythmia in females, though insomnia-associated AF risk was also observed in men. These findings highlight sex-specific associations between sleep disorders and cardiac arrhythmias, emphasizing the need for tailored preventive strategies.</p> Conclusions <p>Across diverse settings, insomnia relates to arrhythmia risk, most convincingly to incident atrial fibrillation with sex-specific differences. Restless legs syndrome exhibits an autonomic profile compatible with arrhythmogenesis. Harmonized, sex-aware prospective studies and trials of insomnia treatment with arrhythmia endpoints are needed.</p>

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Beyond obstructive sleep apnea: a systematic review of sex-specific links between diverse sleep disorders and cardiac arrhythmias

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月20日

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  • Ifeoluwa Sandra Bakare,
  • Folakemi Olori,
  • Chukwumbana Faith Okirie,
  • Hussein Yousif,
  • Abdullahi Opeyemi Hamzah

摘要

Background

Sleep disorders are common yet underexamined in relation to cardiac arrhythmias. We systematically reviewed sex-specific associations between insomnia and restless legs syndrome and arrhythmias, focusing on atrial fibrillation.

Methods

Following a registered protocol (PROSPERO: CRD420251134871), we searched Pubmed(Medline) and performed reference/citation tracking (2015–2025; English). Eligible designs were observational (cohort, case–control, cross-sectional) reporting arrhythmia outcomes and sex-specific data or enabling sex-stratified extraction. Two reviewers screened, extracted data, and assessed risk of bias with ROBINS-E.

Results

Of 127 records, 4 studies met criteria. Insomnia was consistently associated with increased risk of atrial fibrillation (AF) and other arrhythmias across observational studies. Individuals with frequent insomnia had up to a twofold higher AF risk, with elevated vascular resistance observed in restless legs syndrome (RLS). Prospective data showed poor sleep patterns predicted AF incidence, particularly among women. Sex-stratified analyses suggested greater vulnerability to sleep-related arrhythmia in females, though insomnia-associated AF risk was also observed in men. These findings highlight sex-specific associations between sleep disorders and cardiac arrhythmias, emphasizing the need for tailored preventive strategies.

Conclusions

Across diverse settings, insomnia relates to arrhythmia risk, most convincingly to incident atrial fibrillation with sex-specific differences. Restless legs syndrome exhibits an autonomic profile compatible with arrhythmogenesis. Harmonized, sex-aware prospective studies and trials of insomnia treatment with arrhythmia endpoints are needed.