The relationship between stress and sleep quality: The mediating effect of fatigue and dizziness among patients with cardiovascular disease

Abstract

Cardiovascular disease is the leading cause of non-noncommunicable disease mortality worldwide. Therefore, this study analyzes the mediating effect of dizziness and fatigue in the relationship between stress and sleep quality in patients with heart disease. This study was conducted on patients with heart disease diagnosed by a cardiologist from December 7, 2021 to August 30, 2022 at the Outpatient Department of Cardiology at Hanyang University Hospital in Guri-si, Gyeonggi-do. To verify the serial multiple mediation effect, serial multiple mediation analysis was performed using SPSS Macro Process Model 6 as the most appropriate verification method for this study. The analysis indicated that the more dizziness a participant experienced, the more severe their physical and psychological fatigue and the poorer their quality of sleep. Also, the more severe the physical fatigue, the worse the psychological fatigue and the worse the quality of sleep. In other words, the more severe the psychological fatigue, the poorer the quality of sleep. In summary, in the relationship in which stress in patients with heart disease affects sleep quality, stress is a variable that directly affects sleep quality, and this means that the stress of patients with heart disease can affect the quality of sleep through the parameters, dizziness and fatigue, sequentially; this research model can thus be considered a partial mediator model. Fatigue in patients with cardiovascular disease had a direct effect on sleep quality, and there was a mediating effect through dizziness and fatigue in the relationship between stress and sleep quality. Therefore, it is necessary to develop a sleep management program that can improve the quality of sleep in patients with cardiovascular disease as well as a nursing intervention plan that can alleviate fatigue and control stress in such patients.

Causal association between self-reported fatigue and coronary artery disease: a bidirectional two-sample Mendelian randomization analysis

“…The relationship between fatigue and sleep should not be ignored. The latest study reported that both physical and psychological fatigue is associated with sleep quality ( 32 ). A systematic review concluded that there is a significant correlation between short sleep duration, fatigue, and increased incidence of CHD ( 33 ).…”

Factors affecting physical and mental fatigue in adults from South Korea: A cross-sectional study

“…[17,18] Disturbed sleep and poor sleep quality are essential predictors of fatigue. [19][20][21] In terms of the factors associated with fatigue, mechanisms such as overexertion, sleep disturbances, stress, depression, shoulder pain or disability, infections, endocrine disorders, and metabolic conditions have been suggested. [15,16,20,21] However, none of these factors alone can fully explain fatigue.…”

“…[19][20][21] In terms of the factors associated with fatigue, mechanisms such as overexertion, sleep disturbances, stress, depression, shoulder pain or disability, infections, endocrine disorders, and metabolic conditions have been suggested. [15,16,20,21] However, none of these factors alone can fully explain fatigue. Therefore, it is necessary to analyze the various factors influencing fatigue, considering their impact on physical fatigue and mental fatigue.…”