Relation of sleep disturbances to neuroendocrine and coagulation activity in patients with acute myocardial infarction

von Känel, Roland; Princip, Mary; Schmid, Jean-Paul; Barth, Jürgen; Znoj, Hansjörg; Schnyder, Ulrich; Meister-Langraf, Rebecca E. (2017). Relation of sleep disturbances to neuroendocrine and coagulation activity in patients with acute myocardial infarction. Psychoneuroendocrinology, 83(Suppl.), p. 75. Elsevier 10.1016/j.psyneuen.2017.07.441

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Background: Sleep problems predict incident cardiovascular events and mortality. Whether sleep also affects cardiovascular prognosis and through which mechanisms is less clear. We evaluated the relationship of a clinical risk of obstructive sleep apnea (OSA) and insomnia symptoms with neuroendocrine and coagulation activity in patients with acute myocardial infarction.

Methods: Within 48 h of an acute coronary intervention, 190 patients (mean age 60 years, 82.6% male) were interviewed to assess OSA risk (STOP screening tool) and sleep difficulties (Jenkins Sleep Scale). Concentrations of epinephrine, norepinephrine, cortisol, fibrinogen, D-dimer, and von Willebrand factor were measured in plasma/serum. Multivariate models linking sleep to neuroendocrine and coagulation outcomes were controlled for demographic factors, health behaviors, comorbidity and cardiac-related variables, and mutually adjusted for OSA risk and sleep difficulties.

Results: A high risk of OSA was identified in 40.5% of patients, and sleep difficulties on more than seven days in the previous four weeks were reported by 27.4% of patients. Compared to those with a low OSA risk, patients with a high OSA risk had lower epinephrine (p = 0.015), norepinephrine (p = 0.049) and cortisol (p = 0.001) levels, independently of covariates. More sleep difficulties were associated with higher fibrinogen (p = 0.037) and lower norepinephrine (p = 0.024) levels, with difficulties initiating, respectively maintaining sleep, driving these relationships. OSA risk was not significantly associated with coagulation activity.

Conclusions: Sleep problems may relate to neuroendocrine and coagulation activity in patients with acute myocardial infarction. The pattern of relationships is not uniform for OSA and sleep difficulties and even varies between individual sleep difficulties.

Item Type:	Journal Article (Further Contribution)
Division/Institute:	07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology 04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 07 Faculty of Human Sciences > Institute of Psychology 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Psychosomatik
UniBE Contributor:	von Känel, Roland, Princip, Mary, Schmid-Walker, Jean-Paul, Znoj, Hans Jörg, Meister, Rebecca Elisabeth
Subjects:	100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health
ISSN:	0306-4530
Publisher:	Elsevier
Language:	English
Submitter:	Salome Irina Rahel Bötschi
Date Deposited:	26 Feb 2018 15:58
Last Modified:	05 Dec 2022 15:10
Publisher DOI:	10.1016/j.psyneuen.2017.07.441
Additional Information:	Abstract
URI:	https://boris.unibe.ch/id/eprint/111616