Key result
Male AMI patients who sometimes experienced sleep disturbances prior to the event had a 40% increased long-term mortality risk (HR 1.40) compared to those without complaints, unlike female patients.
Why the study?
Sleep-related investigations in acute myocardial infarction patients are rare, prompting the study to examine sex-specific associations between pre-AMI sleep disturbances and long-term survival.
Do patient-reported sleep disturbances within 4 weeks prior to incident acute myocardial infarction affect long-term survival in male and female patients?
Observational (n=3,339)
Yes
Do patient-reported sleep disturbances within 4 weeks prior to incident acute myocardial infarction affect long-term survival in male and female patients?
Effect estimate: HR 1.40 (95% CI 1.08-1.81)
Absolute Event Rate: 28% vs 19%
p-value: p=0.0370
Occasional sleep disturbances prior to an incident acute myocardial infarction are associated with increased long-term all-cause mortality in men, but not in women.
May signal higher long-term risk in men post-AMI; leaves open whether addressing sleep disturbances improves outcomes.
BACKGROUND: Sleep-related investigations in acute myocardial infarction (AMI) patients are rare. The aim of this study was to examine sex-specific associations of patient-reported sleep disturbances within 4 weeks before AMI and long-term survival. METHODS: From a German population-based, regional AMI registry, 2511 men and 828 women, aged 28-74 years, hospitalized with a first-time AMI between 2000 and 2008 and still alive after 28 days, were included in the study (end of follow-up: 12/2011). Frequency of any sleep disturbances within 4 weeks before AMI was inquired by a 6-categorical item summarized to 'never', 'sometimes' and 'nightly'. Cox regression models were calculated. RESULTS: Over the median follow-up time of 6.1 years (IQR: 4.1) sleep disturbances were reported by 32.3% of male and 48.4% of female patients. During the observation period, 318 men (12.7%) and 131 women (15.8%) died. Men who 'sometimes' had sleep disturbances showed a 56% increased mortality risk compared to those without complaints in an age-adjusted model (HR 1.56; 95%-CI 1.21-2.00). Additional adjustment for confounding variables attenuated the effect to 1.40 (95%-CI 1.08-1.81). Corresponding HRs among women were 0.97 (95%-CI 0.65-1.44) and 0.99 (95%-CI 0.66-1.49). HRs for patients with nightly sleep disturbances did not suggest any association for both sexes. CONCLUSIONS: Our study found that nightly sleep disturbances have no influence on long-term survival in male and female AMI patients. Contrary to women, men who reported sometimes sleep disturbances had a higher mortality. Further investigations on this topic taking into account the role of obstructive sleep apnoea are needed.
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Nairz et al. (2018) conducted an observational in Acute myocardial infarction (n=3,339). Sleep disturbances (sometimes) vs. No sleep disturbances (never) was evaluated on All-cause mortality (HR 1.40, 95% CI 1.08-1.81, p=0.0370). Male AMI patients who sometimes experienced sleep disturbances prior to the event had a 40% increased long-term mortality risk (HR 1.40) compared to those without complaints, unlike female patients.
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