The nature of sleep disorders and quality of life against the background of stress in patients with moderate to high cardiovascular risk

Abstract

Objective — to evaluate the dynamics of sleep quality and duration, as well as quality of life after 12 months of follow‑up in patients with moderate to high cardiovascular risk against the background of stress caused by military actions.
 Materials and methods. The prospective, open, non‑placebo controlled investigation has been conducted over 12 months with participation of 87 patients with moderate to high cardiovascular risk. Women prevailed among patients (50 (57.5%)), the mean age was (59.39±12.09) years. Obesity of I degree was established in 47.1%, II degree obesity in 32.3%, III degree obesity in 11.8% of patients, and excessive body mass was registered in 8.8% of the examined subjects. There were no subjects with normal body mass. At baseline, essential hypertension of various stages was established in 58.9% of patients. All patients underwent assessment of cardiovascular risk based on Framingham scale, index of quality of life with SF‑36 «Health Status Survey» questionnaire, stress level with Perceived Stress Scale, presence of sleep disorders with the use of criteria of the International Classification of Sleep Disorders (2014), as well as measurement of anthropometric parameters.
 Results. The prevalence of stress was 100.0% with no significant difference between women (99.8%) and men (100.0%), (OR=0.96 with 95% CI 0.72—1.28). At baseline, circadian disturbances of sleep and alertness prevailed in patients (41%), while after 12 months of observation, insomnia was more common in the entire observation group (55.8%). At the end of the study, the number of patients who had difficulty falling asleep increased (from 35.3% to 81.2%, р <0.05), who had difficulty maintaining uninterrupted sleep (from 38.2% to 66.6%, р <0.05), who had awakening before the planned time (from 58.8% to 75.0%, р <0.05), who had nausea/vomiting as a manifestation of sleep disturbance (from 17.6% to 37.5%, р <0.05), who had deterioration of attention/concentration/memory (from 58.8% to 77.1%, р <0.05).
 Conclusions. Against the background of chronic stress, insomnia prevailed among all sleep disorders in patients with moderate to high cardiovascular risk. As a result of the study, the significant decrease in the quality of life index from 69.7% to 43.2% has been established in this category of patients against the background of chronic stress.