Psychological Disturbances and Their Association with Sleep Disturbance in Patients Admitted for Arrhythmia Diseases

Abstract

Objectives

This study aimed to assess the depression and anxiety status and their association with sleep disturbance among one single center Chinese inpatients with arrhythmia and help cardiologists better identify patients who need psychological care.

Methods

A cross-sectional survey was conducted among 495 inpatients with arrhythmia treated in Fuwai Hospital from October to December 2019. The psychological status and sleep quality were assessed using the Zung Self-Rating Anxiety Scale (SAS), the Zung Self-Rating Depression Scale (SDS) and the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression was used to identify the potential risk factors for anxiety and depression.

Results

The mean age of the participants was 52.8 ± 14.4 years, and 58.0% were male. Approximately 18.3% were in an anxious state, and 33.5% were in a depressive state. In multivariate logistic regression, age from 50 to 59 (p = 0.03), unemployment (p = 0.026) and sleep disturbance (p < 0.001) were the risk factors for anxiety status. Cardiac implanted electronic devices (CIEDs) (p = 0.004) and sleep disturbance (p < 0.001) were the risk factors for depression status. A total of 150 patients (30.3%) were categorized as having poor sleep quality (PSQI > 7). The adjusted odds ratio (OR) of having poor sleep quality was 4.30-fold higher in patients with both anxiety and depression (OR: 4.30; 95% confidence interval [CI]: 2.52–7.35); 2.67-fold higher in patients with depression (OR: 2.67; 95% CI: 1.78–4.00); and 3.94-fold higher in patients with anxiety (OR: 3.94; 95% CI: 2.41–6.44).

Conclusions

Psychological intervention is critical for Chinese inpatients with arrhythmia, especially for patients aged 50–59, unemployed, or those using CIEDs. Poor sleep quality could be an important risk factor linked to psychological disturbances.

Keywords:

• anxiety
• depression
• arrhythmia
• sleep disturbance

Ethics approval

This study was conducted with approval from the Ethics Committee of Fuwai Hospital (2016-780). This study was conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants.

Disclosure

The authors report no conflicts of interest in relation to this work.

Additional information

Funding

National Natural Science Foundation of China (grant numbers 6152 7811 and U1913210).