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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Myocardial ischemia during sleep

M R Bonsignore1, S Smirne, O Marrone

  • 1Istituto di Fisiopatologia Respiratoria del Consiglio Nazionale delle Ricerche, Palermo, Italy.

Sleep Medicine Reviews
|August 18, 2004
PubMed

Insights

Sleep may increase the risk of myocardial ischaemia through different mechanisms during non-rapid eye movement and rapid eye movement sleep stages. Coronary events peak in the morning, but susceptibility to ischaemia may be higher during sleep.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Pathophysiology

Background:

  • The role of sleep in coronary ischaemic events like myocardial infarction is not fully understood.
  • Sleep involves autonomic and cardiovascular changes that could influence myocardial ischaemia.
  • Circadian rhythms and sleep disturbances may impact coronary event occurrence.

Purpose of the Study:

  • To review data on sleep's role in the pathogenesis of coronary ischaemic events.
  • To analyze cardiovascular changes during sleep and their link to ischaemia.
  • To examine the circadian patterns of coronary events and factors in nocturnal angina.

Main Methods:

  • Review of existing literature on sleep, cardiovascular changes, and coronary events.
  • Analysis of data on autonomic and cardiovascular alterations during sleep stages (NREM and REM).
  • Examination of circadian distribution of coronary events and potential triggers for nocturnal angina.

Main Results:

  • Myocardial ischaemia mechanisms differ between non-rapid eye movement (NREM) sleep (decreased perfusion pressure) and rapid eye movement (REM) sleep (increased oxygen demand).
  • Coronary events peak between 6 a.m. and noon, but the ischaemic threshold may be lower during sleep, indicating higher susceptibility.
  • Sleep-disordered breathing, particularly in REM sleep, may trigger nocturnal angina due to reduced arterial oxygen.

Conclusions:

  • Further research is needed on coronary circulation pathophysiology during sleep.
  • Sleep-related factors significantly influence myocardial ischaemia risk and coronary event timing.
  • Understanding sleep's impact is crucial for improving nocturnal angina management.

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