Symptoms of atrial fibrillation and sleep quality in atrial fibrillation: A network analysis

Background : Symptoms of Atrial fibrillation (AF) seriously affect sleep quality and well-being. Understanding their interconnections is crucial for targeted management. Methods : A cohort of 292 patients with AF was recruited through convenience sampling. Data collection included a general information questionnaire, the Chinese Version of the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA), and the Pittsburgh Sleep Quality Index (PSQI). Descriptive statistical analyses and network modeling were performed using SPSS and R. An ASTA-PSQI network was developed to identify core and bridge symptoms. Spearman's rankcorrelation was utilized to assess relationships between symptoms, while the Extended Bayesian Information Criterion graphical least absolute shrinkage and selection operator (EBICglasso) method was employed to mitigate Type I errors. Results : In 292 patients with AF, fatigue was the most common (80.1%) and severe symptom, with a score of 1.26±0.87. Sleep disturbances affected 97.9% of patients, with daytime dysfunction being the most severe (1.53±0.96). Poor sleep quality (PSQI>7) was found in 54.1% of patients. Strong links were noted between weakness/fatigue and fatigue (edge weight=0.63), sleep duration and efficiency (edge weight=0.52), and dyspnea during activity and rest (edge weight=0.35). Weakness/fatigue had the highest centrality and sleep disturbances exhibited the highest bridge centrality. Conclusion : Effective management of AF should focus on controlling disease progression, improving treatment adherence, and reducing weakness/fatigue through exercise, with particular attention to worry/anxiety and sleep disturbances. Clinical trial number: not applicable.