Qualidade do sono em portadores de doença arterial coronariana crônica

Abstract

Background: Sleep disorders have been considered risk factors for cardiovascular disease, including coronary artery disease (CAD). Therefore, poor sleep quality should be frequent complaint in patients with coronary disease. However, in patients with CAD, the prevalence of poor sleepers and factors associated were not properly investigated. Objectives: To evaluate the frequency and the factors associated with poor sleepers in patients with chronic CAD. Method: We used validated questionnaires to examine sleep quality (Pittsburgh Sleep Quality Index; PSQI), high risk of obstructive sleep apnea (Berlin Questionnaire; BQ), excessive sleepiness (Epworth Sleepiness Scale; ESS), angina-related health status (Seattle Angina Questionnaire; SAQ) and quality of life (Medical Outcomes Study 36-item Short Form; SF-36) in 257 volunteers with stable CAD, mean age 62.5 ± 10.5 years. We categorized and compared good and poor sleepers, according to PSQI global score. Subsequently, adjusted analysis was performed to investigate the factors associated with poor sleepers and demographics, clinical characteristics, risk for obstructive sleep apnea, excessive sleepiness, angina-related health status and quality of life. Results: The majority of CAD patients (75.1%) were poor sleepers. The adjusted analysis indicated that older patients (OR 1.05, 95% CI 1.02 to 1.09; p = 0.004), women gender (OR 3.09, 95% CI 1.48 to 6.45; p = 0.003), lower ejection fraction (OR 1.04, 95% CI 1.01 to 1.06; p = 0.015), lower physical limitation (OR 1.03, 95% CI 1.00 to 1.05; p = 0.020), lower angina stability (OR 1.02, 95% CI 1.00 to 1.04; p = 0.027), worse angina-related quality of life (OR 1.03, 95% CI 1.01 to 1.05; p = 0.002) and lower vitality (OR 1.02, 95% CI 1.00 to 01.03; p = 0.042) were associated with poor sleepers. Conclusion: Poor sleepers were highly frequency in chronic CAD patients. Patients with chronic CAD and poor sleepers present higher age, women gender, lower ejection fraction, higher physical limitation, lower angina stability, lower angina-related quality of life and lower vitality.