Exploring sleep, inflammation and myocardial infarction recurrence among older adults

Despite cardiovascular disease being a leading cause of death globally, secondary prevention strategies following myocardial infarction are under-researched compared to primary prevention.

To explore relationships between indicators of sleep quality, inflammation, and myocardial infarction recurrence and the conditional role of psychological stress in these pathways to assess evidence for reducing MI recurrence by improving sleep quality and implementing stress management techniques.

A secondary analysis (N = 156) of cross-sectional study data was conducted. Participants' mean age was 65 years and all had experienced one or more myocardial infarctions within the previous 3-7 years. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Inflammatory markers were collected via blood assay and included C-reactive protein, interleukin-6, and tumor necrosis factor-alpha. Psychological stress was evaluated using a self-reported Likert-scale question. Correlational analysis and conditional path analyses examined relationships between variables of interest.

In this cross-sectional analysis, significant associations were observed between sleep quality, inflammation, psychological stress, and MI recurrence. Sleep quality was associated with inflammatory markers in bivariate analyses, but these relationships did not remain significant in conditional path analyses. Psychological stress moderated the relationship between sleep quality and MI recurrence, with higher stress amplifying the risk. Sleep quality did not directly predict MI recurrence.

Findings suggest that improving sleep quality may be an effective secondary prevention strategy for reducing MI recurrence. The effect may be increased when combined with targeted stress management interventions. Further research is warranted to explore biobehavioral mechanisms underlying these associations to develop targeted interventions for aging individuals at risk.