The predictive value of anxiety scores for insomnia in older patients with coronary heart disease: an analysis of 206 cases

BACKGROUND: Sleep disturbance has been associated with an elevated risk of coronary heart disease and its progression. The objective of this study was to delineate and ascertain the relationship between anxiety scores and sleep disturbance in elderly patients suffering from coronary heart disease. METHODS: Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for poor sleep quality, as measured by the Athens Insomnia Scale (AIS). Propensity score matching (PSM) was used to exclude confounders before assessing the association between poor sleep quality and coronary heart disease progression, as measured by the frequency of repeat hospitalization for angina. RESULTS: In the current cohort of 206 patients, 125 (60.7%) exhibited suboptimal sleep quality. Univariate analysis revealed associations between poor sleep quality and male gender, mean hemoglobin concentration (MCHC), and a higher Hamilton Anxiety Rating Scale (HMAM) score. Spearman correlation analysis indicated a significant positive correlation between the HMAM score and the Athens Insomnia Scale (AIS) score (r = 0.601, P < 0.01). Multivariate logistic regression analysis identified a history of kidney disease and the HMAM score as independent risk factors for suboptimal sleep quality (P = 0.02 and P < 0.001, respectively). Following propensity score matching (PSM), the poor sleep quality group exhibited a significantly higher number of repeat hospitalizations compared to the good sleep quality group (P < 0.01). CONCLUSIONS: The HAMA anxiety score can serve as a valuable tool in detecting sleep disturbances among older patients suffering from coronary heart disease. A notable correlation exists between suboptimal sleep quality and the likelihood of readmission due to angina following discharge. Consequently, implementing treatment strategies aimed at alleviating anxiety and insomnia in these patients may potentially enhance their long-term prognoses.