Features of emotional status and autonomic regulation in patients with ischemic heart disease with sleep disorders

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OBJECTIVE

To study the features of the emotional status and autonomic regulation in patients with coronary heart disease and sleep disorders.

MATERIAL AND METHODS

Patients with angina pectoris of II-IV functional class (n=244), aged 36 to 72 years (average age 56.9±0.5 years), were examined. Emotional status was assessed by the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory, the State-Trait Anxiety Inventory. The vegetative status was studied by heart rate variability based on 5-minute recordings of cardiointervalogram and D.J. Ewing cardiovascular tests and a vegetative disorders questionnaire. Patients were divided into 2 groups depending on the severity of sleep disorders.

RESULTS

Sixty-two patients (25.4%) had no sleep disorders (≥22 points on the sleep quality questionnaire), they were included in the 2^nd group; 113 patients (46.3%) had severe sleep disorders (≤18 points on the sleep quality questionnaire), these patients were included in the 1^st group, 69 patients (28.3%) had sleep disorders assessed as insignificant (from 19 to 21 points on the sleep quality questionnaire). The HADS scores for anxiety and depression were 9.2±0.4 and 7.7±0.4, respectively, in the 1^st group; in the 2^nd group the levels of anxiety and depression were 5.9±0.4 and 3.9±0.4 points (p<0.001). Clinically expressed autonomic disorders were observed in 100% of patients in the 1^st group and in 75.8% in the 2^nd group (p<0.001). The average score on the questionnaire of autonomic disorders was 41.8±1.2 in the 1^st group, and 25.6±1.6 points in the 2^nd group (p<0.001).

CONCLUSION

In patients with sleep disorders, a higher level of anxiety, depression, autonomic disorders and lower heart rate variability were detected, which is an unfavourable prognostic sign that should be considered in treatment and rehabilitation of these patients.

Keywords:

coronary heart disease

anxiety

depression

sleep disorders

Authors:

Ibatov A.D.

Sechenov First Moscow State Medical University

Received:

17.03.2020

Accepted:

06.05.2020

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