The Significance of Sleep Disorders in Post-myocardial Infarction Depression

Abstract

Sleep disorders are highly prevalent and often missed comorbidities in patients with cardiovascular disease (CVD), especially important in patients with depression associated with post-myocardial infarction (MI). Proactive screening and targeted treatment for sleep disorders are essential to reduce the morbidity and mortality associated with CVDs and MI in particular. We have reviewed all relevant information up to July 2022 regarding sleep disorders in CVD with a focus on post-MI depression and gathered around 350 articles in our research and narrowed it down to 31 articles. The database used was PubMed, and the keywords used were obstructive sleep apnea, sleep disorders, sleep-disordered breathing, major depression, and post-myocardial infarction. We have concluded from the available literature that there is a significant overlap between the etiologies and pathological mechanisms between conditions such as diabetes, obesity, and other comorbidities associated with both sleep disorders and CVD. Treatment such as psychotherapy and pharmacotherapy should be tailored according to the specific needs of the patients. Targeted treatment for sleep disorders has been shown to improve multiple factors and comorbidities associated with prognosis post-MI, including improvement in quality of life and significantly reduced short-term and long-term mortality. The incidence and prevalence of depression post-MI can be significantly reduced by focusing on the treatment of any underlying sleep disorders. We encourage larger-scale observational and interventional studies regarding the quality of sleep post-MI.

Keywords: major depression disorder; myocardial infarction; post-myocardial infarction; sleep apnea syndrome; sleep disorders.

Figure 1. The risk factors for sleep disorders.

Figure 2. The comorbidities associated with sleep disorders.

Figure 3. Mechanisms associated with cardiovascular disease morbidity and sleep disorders.