Insomnia in patients with coronary heart disease: prevalence and correlates

Lars Aastebøl Frøjd, John Munkhaugen, Torbjørn Moum, Elise Sverre,  Inger Hilde Nordhus, Costas Papageorgiou, Toril Dammen

Studien er publisert i Journal of Clinical Medicine

Study objectives: To determine the prevalence of insomnia and its association with clinical and psychosocial factors in a large sample of outpatients with coronary heart disease (CHD).
Methods: The sample comprised 1082 patients, mean age 62 years (21% female), who participated in the cross-sectional NORwegian CORonary Prevention Study. Patients who were hospitalized with myocardial infarction and/or a coronary revascularization procedure in 2011-14 responded to a self-report questionnaire and participated in a clinical examination with blood samples 2-36 (mean 16) months later. Insomnia was assessed using the Bergen insomnia scale, a questionnaire based on the criteria for the clinical diagnosis of insomnia described in the Diagnostic and Statistical manual, 4th version (DSM-IV-TR). We performed bivariate logistic regressions for crude analysis and backwards stepwise logistic regressions for multi-adjusted odds ratios.
Results: In total, 488 patients (45%) reported insomnia and 24% of these patients used sleep medication in the previous week. Anxiety symptoms (OR: 5.61) were the strongest determinants of insomnia, followed by female sex (OR: 1.88), diabetes (OR: 1.83), eating fish less than 3 times a week (OR: 1.69), type D personality (OR: 1.69), and CRP ≥2 mg/L (OR:1.58), in multi-adjusted analyses.
Conclusions: Insomnia was highly prevalent in CHD outpatients. Both psychological factors, lifestyle factors and subclinical inflammation were associated with insomnia. Our results emphasize the need to identify patients with insomnia and provide appropriate management of insomnia in outpatients with CHD.