Exploring the Interaction Between Sleep Patterns, Cardiac Autonomic Function, and Traditional Cardiovascular Risk Factors Following Acute Myocardial Infarction

Background

Monitoring lifestyle habits and physiological metrics are essential for improving cardiovascular outcomes and supporting recovery after acute cardiac events. Sleep is acknowledged as a core component of cardiovascular health and a predictive tool of adverse outcomes following acute myocardial infarction (AMI).

Objective

The present study aimed to assess sleep metrics and explore the links between sleep patterns, heart rate variability (HRV) parameters, and traditional cardiovascular risk factors in patients with AMI.

Methods

Sixty male patients with AMI (56.77 ± 8.24 years) participated in this study. Cardiac autonomic function was assessed with short-term HRV analysis during the second week post-AMI. Physical activity level was assessed using accelerometers. Sleep quality and quantity were evaluated objectively using a wrist-worn accelerometer and subjectively by the Pittsburgh Sleep Quality Index. Chronotype was evaluated with the Horne and Otsberg questionnaire.

Results

Twenty post-AMI patients (33.3%) tended to experience poor sleep quality, with a sleep efficiency inferior to 85%. Thirty patients (50%) experienced short sleep duration, 16 (26.7%) had a healthy sleep duration (7−8 h), and 14 (23.3%) slept more than 8 h. Multiple regression analysis revealed that patients with healthy sleep quality and quantity exhibited higher HRV parameters, both in time and frequency domain values (p < 0.05). Low physical activity level was observed in patients with long sleep duration (p = 0.005) and evening chronotype (p = 0.022).

Conclusion

Patients who spent more time performing moderate to vigorous physical activity tended to exhibit good sleep health and increased parasympathetic activity which are considered cardioprotective after AMI.

Trial Registration: PACTR202208834230748.