JMIR Publications

ABSTRACT

Background:

Patients can have disturbed sleep and circadian rhythm after with acute myocardial infarction (MI), and their correlations with prognosis is still unclear.

Objective:

We aimed to evaluate the impact of sleep patterns and circadian rhythm disruptions on the prognosis of patients with MI through actigraphy and heart rate variability (HRV). Non-parametric analysis of actigraphy data was use to evaluate patients’ circadian rhtyhm.

Methods:

Patients with MI were enrolled in the intensive care unit (ICU) with an age and gender matched healthy control group. Actigraphy was utilized for continuous monitoring of sleep and circadian rhythm patterns, while HRV was assessed for 24 hours to evaluate autonomic nerve function. Follow-ups were conducted at 3 and 6 months after discharge to evaluate prognosis. Mann-Whitney U tests were used to compare differences between the MI and control groups and Pearson's correlation test to explore the correlations between parameters of actigraphy, HRV and prognosis.

Results:

Thirty-four patients with MI (mean age 57.65±9.03 years old, 85.3% males) and 17 healthy controls were included. Compared to the control group, MI patients had a significantly longer sleep onset latency, more wake after sleep onset, increased number of awakening, and lower sleep efficiency than controls. Circadian rhythm analysis revealed lower activity during awake, less daytime and nighttime activity changes, less active-rest rhythm and more delayed circadian rhythm. Besides correlations between HRV and prognosis, significant correlations were also found between parameters of circadian rhythm analysis and prognosis.

Conclusions:

Our actigraphy-based analysis revealed poor sleep and disturbed circadian rhythm in patients with acute MI, which correlated with prognosis. The evaluation of sleep and circadian rhythm can serve as a valuable marker for the prognosis of MI.