Prevalence and Determinants of Insomnia After a Myocardial Infarction

Abstract

This study analyzed cross-sectional data to examine the prevalence of insomnia and to identify factors associated with insomnia after a myocardial infarction (MI). The participants were 209 individuals with a recent MI. At approximately 5 weeks post-MI, participants completed standardized self-report measures assessing insomnia (Insomnia Severity Index) and various sociodemographic, clinical, behavioral, and psychosocial variables, including stressful life events, depressive symptoms, and dysfunctional beliefs about sleep. Overall, 36% of the sample reported clinical symptoms of insomnia (Insomnia Severity Index score ≥ 10) and an additional 9% reported milder/subthreshold symptoms (Insomnia Severity Index score ≥ 8). Among patients with insomnia, a much higher proportion (62.7%) were experiencing symptoms consistent with depressed mood compared to good sleepers (13.4%). Multivariate linear regression showed that younger age, use of prescribed medication for sleep, more depressive symptoms, and greater dysfunctional beliefs about sleep were associated with insomnia severity. Many patients after MI experience insomnia, which may increase the illness burden and hamper recovery during the cardiac rehabilitation phase. Our findings provide a theoretical basis for evaluating cognitive-behavioral approaches for the management of insomnia in patients after MI.