Impact of Sleep Disruptions on the Mental Health of Atrial Fibrillation Inpatients: A Cross-Sectional Study

Author(s): Lixing Hu, Xiaotong Ding, Min Tang.

Objectives: To evaluate the interactions between anxiety, depression and sleep attributes in atrial fibrillation inpatients of a single tertiary center in China to improve identification of patients who require additional psychological care.

Methods: We retrospectively enrolled 332 atrial fibrillation inpatients and evaluated their psychological and sleep status with the Zung Self- Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Potential risk factors for anxiety and depression were analyzed by multivariate logistic regression. Odds ratios (OR) for risk of poor sleep quality were adjusted by age and gender in patients with different psychological statuses (anxiety only, depression only, combined anxiety and depression).

Results: Participants with an average age of 58.6±10.5 years, and 67.8% males were involved in the study. Patients with anxiety and depression accounted for 21.1 and 34.0%, respectively. Potential risk factors for anxiety were female (P = 0.045) and poor sleep quality (P = 0.001); for depression were obesity (P = 0.033) and poor sleep quality (P<0.001). The likelihood of experiencing sleep disturbances was 3.69 times greater in patients suffering from both anxiety and depression (OR: 3.69; 95% confidence interval [CI]: 1.94–7.01; P<0.001), 2.14 times greater in depressed patients (OR: 2.14; 95% CI: 1.16–3.96; P = 0.016), and 2.06 times greater in anxious patients (OR=2.06; 95%CI: 0.72-5.94; P = 0.180).

Conclusions: Psychological disturbances are prevalent among Chinese inpatients with atrial fibrillation, especially among females and obese individuals. There is an association between anxiety and depression respectively, with sleep disorders. Persistent sleep disruption may be a significant risk factor for psychological disorders, and patients suffering from anxiety and depression have the highest risk for sleep disruption.

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