Peak time of acute coronary syndrome in patients with sleep disordered breathing

Ishibashi, Yutaka; Osada, Naohiko; Sekiduka, Hiromitsu; Izumo, Masaki; Sugiyama, Takashi; Hayashi, Akio; Kida, Kenji; Yoneyama, Kihei; Takahashi, Eiji; Suzuki, Kazuhiro; Tamura, Masachika; Akashi, Yoshihiro; Inoue, Kentaro; Omiya, Kazuto; Miyake, Fumihiko; Izawa, Kazuhiro P.; Watanabe, Satoshi

doi:10.1016/j.jjcc.2008.09.014

Cited by 16 publications

(12 citation statements)

References 19 publications

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“…However, the rate of sleep apnea we found in our subsample may be an overestimation because those undergoing PSG had a somewhat higher BMI (33.6 ± 6.8) versus those who did not (30.6 ± 7.2). Nonetheless, others have previously reported a high prevalence of sleep apnea in ACS patients before discharge 3 days 46) and 2-3 weeks 47) after the acute event. Sleep apnea has significant negative effects on quality of life and also predicts in-hospital recurrent cardiac events in ACS patients.…”

Section: Discussionmentioning

confidence: 90%

Clinical Correlates of Insomnia in Patients With Acute Coronary Syndrome

et al. 2013

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SummaryThis study sought to examine the prevalence of insomnia and its association with depression, anxiety, and medical comorbidities in patients after an acute coronary syndrome (ACS). Insomnia increases risk of recurrent cardiac events in ACS patients, but little is known about the prevalence and clinical correlates of insomnia in this setting. Patients (n = 102, 58.3 ± 10.6 years-old) admitted for ACS to a cardiology service at an urban academic medical center completed the Insomnia Severity Index, Epworth Sleepiness Scale, and measures of depression and anxiety. A subset (n = 20) completed ambulatory polysomnography (PSG) in their homes several weeks after discharge. Moderate or severe insomnia was reported by 37% of patients during hospitalization and was associated with 76 minutes more wake after sleep onset measured by home PSG. Although depression and insomnia were strongly associated, about 1 in 4 patients with insomnia did not report significant depressive symptoms. Sleep apnea was documented in 80% of patients on PSG, but insomnia was not associated with sleep apnea, periodic limb movements, demographic factors, or medical conditions other than liver disease. Insomnia is present in over one-third of ACS patients during hospitalization, but at-risk patients could not be readily identified by demographic or medical factors or by depression symptoms. (Int Heart J 2013; 54: 258-265) Key words: Sleep, Myocardial infarction, Angina, Depression A s many as 1 in 3 patients with acute coronary syndrome (ACS) suffer from significant psychological distress, such as depression and anxiety.1,2) Among ACS patients, depression and anxiety are associated with increased mortality, 3,4) diminished quality of life, 5) increased health care costs, 6) and reduced adherence to recommendations intended to decrease the risk of cardiac events. 7) Although insomnia is common among individuals with psychological distress, the literature on depression and anxiety as risk factors for ACS morbidity and mortality has largely ignored its potential impact in ACS patients. Instead, most of the literature on sleep in patients with heart disease has focused almost exclusively on sleep apnea due to known associations between sleep-disordered breathing (SDB) and cardiovascular morbidity. 8) Insomnia, however, is often unrelated to SDB 9,10) and is important to consider in ACS patients since poor sleep quality is associated with a 2.5-fold increased risk of recurrent cardiac events in women after an ACS.11) Insomnia has also been linked to increased morbidity, 12) mortality, 13) and health care costs 14) independent of psychological distress and in some cases, independent of SDB and periodic limb movements as well. 12)To our knowledge, no study has examined insomnia in an ACS population using a reliable, validated self-report instrument of insomnia severity that not only assesses sleep continuity and quality, but also inquires about important consequences of poor sleep, such as daytime impairment or distress.15-17) As such, this study ...

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Section: Discussionmentioning

confidence: 90%

Clinical Correlates of Insomnia in Patients With Acute Coronary Syndrome

et al. 2013

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“…The prevalence of OSA is 2-to 3-fold higher in patients with a history of myocardial infarction (MI). 95 Recent studies have also reported that the odds of having OSA in patients with nocturnal onset of MI was 6-fold higher than in those with MI onset during the daytime, suggesting that OSA leads to an increased risk of MI during the night 96,97 (Figure 4). Patients who suffer from ischemic heart disease and OSA may be at a higher risk for STsegment depression during sleep.…”

Section: Cadmentioning

confidence: 99%

Obstructive Sleep Apnea and Cardiovascular Disease

Kato

Adachi

Koshino

et al. 2009

Circ J

104

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“…Patients with SDB are more likely to have cardiac events during nocturnal hours [30]. Acute coronary syndromes (ACS) are more frequent during night time in OSA patients as opposed to the well-documented diurnal pattern of presentation in the general population [31].…”

Section: Ischaemic Heart Diseasementioning

confidence: 99%

The Association of Sleep Disordered Breathing with Heart Failure and Other Cardiovascular Conditions

Stopford

Ravi

Nayar

2013

Cardiology Research and Practice

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An abundance of evidence exists in support of primary and secondary prevention for tackling the scourge of cardiovascular disease. Despite our wealth of knowledge, certain deficiencies still remain. One such example is the association between sleep disordered breathing (SDB) and cardiovascular disease. A clear body of evidence exists to link these two disease entities (independent of other factors such as obesity and smoking), yet our awareness of this association and its clinical implication does not match that of other established cardiovascular risk factors. Here, we outline the available evidence linking SDB and cardiovascular disease as well as discussing the potential consequences and management in the cardiovascular disease population.

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Peak time of acute coronary syndrome in patients with sleep disordered breathing

Abstract: The results of this study suggest a possible relationship between SDB and the onset of ACS between midnight to morning.

Cited by 16 publications

References 19 publications

Clinical Correlates of Insomnia in Patients With Acute Coronary Syndrome

Clinical Correlates of Insomnia in Patients With Acute Coronary Syndrome

Obstructive Sleep Apnea and Cardiovascular Disease

The Association of Sleep Disordered Breathing with Heart Failure and Other Cardiovascular Conditions

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