Characteristics of Emotional Status and Autonomic Regulation in Patients with Ischemic Heart Disease and Sleep Disorders

Objectives: To study the features of emotional status and autonomic regulation in patients with ischemic heart disease and sleep disorders. Materials and methods. A total of 244 patients with functional class II–IV effort angina aged 36–72 (mean 56.9 ± 0.5 years) were studied. Emotional status was evaluated on the Hospital Anxiety and Depression Scale (HADS), the Beck Scale, and the Spielberger Scale. Autonomic status was assessed in terms of heart rate variability using 5-min cardiointervalogram traces at rest, Ewing cardiovascular tests, and an autonomic disorders questionnaire. Patients were divided into two groups depending on the severity of sleep impairments. Results. A total of 62 patients in the study cohort (25.4%) had no significant sleep impairment (≥22 points on the sleep quality questionnaire; these patients constituted group 2); 113 patients (46.3%) had severe sleep impairments (≤18 points on the sleep quality questionnaire; these patients constituted group 1); 69 patients (28.3%) had minor sleep impairments (19–21 points on the sleep quality questionnaire). Levels of anxiety and depression on the HADS were 9.2 ± 0.4 and 7.7 ± 0.4 points in group 1, compared with 5.9 ± 0.4 and 3.9 ± 0.4 points in group 2 (p < 0.001). Clinically marked autonomic disorders were seen in 100% of patients in group 1 and 75.8% of those in group 2 (p < 0.001). Mean scores on the autonomic impairments questionnaire were 41.8 ± 1.2 in group 1 and 25.6 ± 1.6 in group 2 (p < 0.001). Conclusions. Patients with sleep disorders had higher levels of anxiety, depression, and autonomic impairments, as well as lesser heart rhythm variability, which are unfavorable prognostic signs. This requires improvements in therapeutic and rehabilitation measures in this category of patients. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.