Frequent nightmares linked to psychological disturbances in patients with CVD
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Frequent nightmares were associated with psychological disturbances and insomnia in patients hospitalized for CVD, according to a study published in the European Journal of Cardiovascular Nursing.
“The patients with CV diseases have a variety of correlates of nightmares. For instance, a high incidence of sleep and psychological disturbances has been observed in patients with CV diseases and the association of these disturbances with the development of various CV diseases has been increasingly recognized,” Haruaki Horie, PhD, project professor in the department of cardiology at Keio University School of Medicine in Tokyo, and colleagues wrote. “Patients with CV diseases frequently use medications that have been reported to be associated with nightmares. ... However, the prevalence and determinant factors of nightmares have not been clarified.”
In an observational, cross-sectional study, researchers evaluated 1,233 patients (mean age, 64 years; 25% women) with various CVDs for nightmares and sleep characteristics. Enrolled patients completed questionnaires on insomnia and psychological disturbances; investigators gathered further data on sleep characteristics using Pittsburgh Sleep Quality Index (PSQI) scores, on sleep-disordered breathing (SDB) using pulse oximetry and on psychological disturbances using the Hospital Anxiety and Depression Scale (HADS).
Study results showed 14.8% of patients had at least one nightmare per month and 3.6% of patients had nightmares at least once per week. Upon further analysis, researchers noted 45.9% of patients had insomnia (modified PSQI > 5), 28% of patients had SDB (3% oxygen desaturation index > 15), 18.5% of patients had depression (HADS-depression 8) and 16.9% of patients had anxiety (HADS-anxiety 8).
Frequent nightmares were associated with depression (OR = 4.61; 95% CI, 2.03-10.48), anxiety (OR = 5.32; 95% CI, 2.36-12.01) and insomnia (OR = 7.15; 95% CI, 2.41-21.22), according to the researchers.
Prescription rates of CV medications did not differ between patient groups and was therefore not associated with frequent nightmares, according to the researchers. Sleep-disordered breathing was also not associated with frequent nightmares.
“Frequent nightmares were not uncommon in patients hospitalized for CV diseases. Although the cause-effect relationship is unclear, frequent nightmares were associated with psychological disturbances and insomnia ... but not SDB and use of CV medications,” Horie and colleagues wrote. “Cardiologists should be more conscientious to nightmare complaints with respect to screening for psychological disturbances and insomnia.”
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