Objective and Subjective Multidimensional Sleep Health in Women After Myocardial Infarction

Poor sleep after acute cardiovascular events is associated with increased mortality. Women are more likely than men to report sleep disturbances after cardiovascular events, but other sleep metrics linked to cardiometabolic health remain underexplored.

We characterize multiple dimensions of sleep and examine factors associated with poor sleep among women with prior myocardial infarction (MI).

Participants completed 7 nights of wrist actigraphy, which measured sleep duration, sleep efficiency, and wake after sleep onset (WASO), and sleep diary, which measured self-reported sleep quality using a Likert scale. Multivariable regression modeled associations between sociodemographic, clinical, and psychosocial characteristics and sleep measures.

Among 94 post-MI women (median days since MI 93; IQR: 69-709), mean age was 60 years, and 67.0% identified as non-Hispanic White. The mean sleep duration was 405.1 minutes (approximately 6.8 hours), sleep efficiency 86.3%, WASO 61.6 minutes, and self-reported sleep quality 3.3, indicating fair-to-good sleep quality. Overall, 64.9% of women had short (<7 hours) or long (>9 hours) sleep duration, 33% low sleep efficiency (<85%), and 88.3% long WASO (>30 minutes). In exploratory analyses, associations with poor sleep included identifying as other than non-Hispanic White (shorter sleep duration, lower efficiency, and longer WASO), being nonpartnered (shorter sleep duration), hypertension (lower sleep efficiency), and higher depressive symptoms (lower sleep quality).

Many women with prior MI had suboptimal sleep (short or long sleep duration, low sleep efficiency, and/or long WASO). Our results highlight the importance of discussing multiple dimensions of sleep with women post-MI to optimize cardiovascular health.