Insomnia Symptoms and Acute Coronary Syndrome-Induced Posttraumatic Stress Symptoms: A Comprehensive Analysis of Cross-sectional and Prospective Associations.
Ann Behav Med
; 55(10): 1019-1030, 2021 10 04.
Article
em En
| MEDLINE
| ID: mdl-33580657
ABSTRACT
BACKGROUND:
Acute coronary syndrome (ACS) induces clinically significant posttraumatic stress symptoms (PTSS) in 12% of patients. Subjective sleep problems are a risk factor for the development of PTSS, but this is underexplored in patients with ACS.PURPOSE:
To examine the association of insomnia symptoms with ACS-induced PTSS.METHODS:
In this longitudinal study with 154 patients (all white, 84.4% male, mean age 58.7 years) with a verified ACS, insomnia symptoms were interviewer assessed at hospital admission and at 3 months, using the Jenkins Sleep Scale (JSS)-4. ACS-induced PTSS were assessed with the Clinician-Administered Posttraumatic Stress Disorder Scale 3 months after hospital admission. In multivariable linear models, insomnia symptoms were regressed on PTSS, adjusting for demographics, clinical variables, health behaviors, and psychological data, including cognitive depressive symptoms.RESULTS:
Greater insomnia symptoms at admission (ß = .165, p = .034), greater increase in insomnia symptoms from admission to 3 months (ß = .233, p = .008), and greater insomnia symptoms at 3 months (ß = .239, p = .002) were independently associated with more severe total PTSS at 3 months. Concerning the individual PTSS clusters, both insomnia symptoms at admission (ß = .214, p = .007) and at 3 months (ß = .213, p = .012) were independently associated with reeexperiencing symptoms. Removing sleep items from PTSS scores and excluding patients on antidepressants in two sensitivity analyses did not substantially change the results.CONCLUSIONS:
Insomnia symptoms could play an important role in the development and severity of ACS-induced PTSS. This relationship seems not simply explained by the fact that sleeping difficulties are inherent to the phenotype of posttraumatic stress disorder. CLINICAL TRIAL INFORMATION NCT01781247.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transtornos de Estresse Pós-Traumáticos
/
Síndrome Coronariana Aguda
/
Distúrbios do Início e da Manutenção do Sono
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article