Analysis Of Insomnia And Its Influencing Factors In Patients With Acute Coronary Syndrome

Objective: To investigate the status and one-year outcome of insomnia in patients with acute coronary syndrome(ACS),analyze the influencing factors of insomnia in ACS patients,and provide the basis for making insomnia strategies for ACS patients.Methods: from March 2015 to June 2019,771 patients with ACS who met the criteria were selected.After 7 days of hospitalization,baseline social demographic information,sleep quality questionnaire,general anxiety scale(GAD7),patient health questionaire(9 items)were completed,PHQ9),quality of life scale 12(SF12)and Social Support Inventory(ESSI)were followed up for one year,and the factors affecting insomnia in ACS patients were analyzed by logistic regression equation.Two independent samples of t-test were used to analyze and compare the differences of blood coagulation indexes between 90 ACS patients with severe insomnia and ACS patients without insomnia.Results: a total of 741 valid questionnaires were collected,510 males(68.8%)and 231 females(31.2%).487(65.7%)had at least one InsomniaSymptom,308(41.6%)had difficulty in falling asleep,369(49.8%)had difficulty in waking up at night,116(15.7%),74(10.0%)had difficulty in waking up and falling asleep at the same time,53(7.2%)had difficulty in waking up,waking up at night and falling asleep at the same time.Logistic regression analysis showed that before admission,physical activity [OR=0.636,CI 95%(0.411,0.984)],depression [OR= 1.908,CI 95%(1.101,3.305)] and low social support [OR= 0.278,CI 95%(1.198,3.301)] were independent factors of insomnia in ACS patients.The indexes of blood coagulation in ACS patients with severe insomnia were higher than those in ACS group,and there was no statistical difference in troponin(P = 0.6),D-dimer group(P = 0.07),fibrinogen(P < 0.01),platelet count(P < 0.05)and mean blood platelet volume(P < 0.05).Severe insomnia was the high risk of blood coagulation in ACS patients at the acute stage of hospitalization Risk factors.Conclusion: nearly 2 / 3 of ACS patients have insomnia symptoms,difficulty in falling asleep and easy to wake up at night are the most common manifestations;physical activity,depression and social support are independently related to insomnia.Severe insomnia will aggravate the risk of coagulation in ACS patients.