Clinical Report: Insomnia Prevalence and Risk Factors in Coronary Heart Disease
Overview
This systematic review and meta-analysis found that insomnia affects approximately 51.8% of patients with coronary heart disease (CHD). Key risk factors include female sex, anxiety, depression, longer CHD duration, diabetes, and gastritis.
Background
Coronary heart disease (CHD) remains a leading cause of morbidity and mortality worldwide. Sleep health, particularly insomnia, plays a critical role in cardiovascular outcomes but is often underrecognized in CHD management. Insomnia can exacerbate CHD through sympathetic activation and inflammatory pathways, increasing adverse cardiovascular risks. Despite its importance, the true prevalence and contributing factors of insomnia in CHD patients have been inconsistently reported.
Data Highlights
Parameter
Odds Ratio (OR)
95% Confidence Interval (CI)
P-value
Overall Insomnia Prevalence
—
0.446–0.590
<0.001
Female Sex
2.00
1.58–2.52
<0.001
Anxiety
1.61
1.36–1.91
<0.001
Depression
2.15
1.48–3.13
<0.001
CHD Duration ≥3 years
1.73
1.25–2.40
0.001
Diabetes
1.50
1.45–1.56
<0.001
Gastritis
2.24
1.62–3.11
<0.001
Key Findings
Insomnia prevalence in CHD patients is high at 51.8% (95% CI: 44.6%–59.0%).
Female patients have double the odds of insomnia compared to males (OR = 2.00).
Anxiety and depression significantly increase insomnia risk, with ORs of 1.61 and 2.15 respectively.
Longer CHD duration (≥3 years) is associated with a 73% increased risk of insomnia.
Comorbid diabetes and gastritis are notable risk factors, increasing insomnia odds by 50% and 124%, respectively.
Clinical Implications
Clinicians managing CHD patients should routinely screen for insomnia, especially in females and those with longer disease duration. Early identification and targeted interventions addressing modifiable factors such as anxiety, depression, diabetes, and gastritis may improve sleep quality and potentially cardiovascular outcomes. Integrating sleep assessment into CHD care protocols is recommended to optimize patient management.
Conclusion
Insomnia is highly prevalent among patients with coronary heart disease and is influenced by multiple demographic and clinical factors. Prioritizing insomnia recognition and management may enhance overall cardiovascular health and patient quality of life.
