title: Disturbed sleep, fatigue, anxiety and depression in myocardial infarction patients.
abstract: BACKGROUND
  Disturbed sleep has been linked to increased morbidity, mortality and depression and worsened health-related quality of life in patients with chronic illness. Few studies of readjustment after coronary artery disease have explicitly focused on sleep disturbance.
  
  
  OBJECTIVE
  To explore associations between disturbed sleep, fatigue, anxiety and depression, and to assess to what extent fatigue four months post-MI could be explained.
  
  
  METHODS
  The sample included 204 consecutive patients, <or=80 years of age who answered questionnaires about disturbed sleep, fatigue, anxiety and depression four months after MI.
  
  
  RESULTS
  The variables anxiety, depression and disturbed sleep were all associated with fatigue. The regression model accounted for 46% of the variance in fatigue with depression and disturbed sleep as predictors. Infarct size measured by conventional biochemical markers, left ventricle ejection fraction and history of previous MI were not correlated with disturbed sleep, fatigue, anxiety or depression.
  
  
  CONCLUSIONS
  From knowledge about associations between disturbed sleep, fatigue, anxiety and depression after MI, cardiac nurses could be trained to observe such symptoms. Optimal care for sleep disturbance may include actions to reduce anxiety and depression as well as self-care advices about sleep hygiene in order to improve sleep quality and reduce fatigue.
authors.affiliation: Department of Internal Medicine, NU Hospital group, Sweden.
authors.forename: Ingvor
authors.initials: I
authors.lastname: Johansson
authors.forename: Björn W
authors.initials: BW
authors.lastname: Karlson
authors.forename: Gunne
authors.initials: G
authors.lastname: Grankvist
authors.forename: Eva
authors.initials: E
authors.lastname: Brink
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000453:epidemiology*