Poor Sleep May Trigger Heart Attacks

Heart attack survivors with PTSD may have more cardiac events linked to poor sleep

(RxWiki News) For heart attack patients, getting post-traumatic stress disorder is fairly common. Those with PTSD are also likely to have another cardiac event, and sleep troubles may play a role.

Most people think of PTSD as a disorder of combat veterans and sexual assault survivors.  But one in eight people who suffer a heart attack or other acute coronary event experience the symptoms of PTSD, according to previous research. 

New research has found that PTSD following a heart attack is associated with poor sleep as well.

"Get a good night’s rest to help your heart."

Jonathan A. Shaffer, PhD, associate professor of clinical medical sciences at the Center for Behavioral Cardiovascular Health at Columbia University in New York City, and his colleagues observed nearly 200 patients who had experienced a heart attack within the previous month.

The results showed that the more heart attack-induced PTSD symptoms patients reported, the worse their overall self-reported sleep was in the month following their heart attack.

Greater PTSD symptoms following a heart attack were linked with worse sleep quality, shorter sleep duration, more sleep disturbances, use of sleeping medications and daytime dysfunction due to poor sleep the night before.

In 2012, an investigation led by Donald Edmondson, PhD, a colleague of Dr. Shaffer’s at the Center, reported that heart patients who suffer PTSD face twice the risk of having another cardiac event or of dying within one to three years, compared with survivors without PTSD.

PTSD is an anxiety disorder initiated by exposure to a traumatic event such as a heart attack, combat, disaster or sexual assault. Common symptoms include nightmares, avoidance of reminders of the event, and elevated heart rate and blood pressure.

“Fortunately, there are good treatments for people with PTSD,” Dr. Edmondson said. “But first, physicians and patients have to be aware that this is a problem. Family members can also help. We know that social support is a good protective factor against PTSD due to any type of traumatic event.”

The authors of this research hypothesize that the strong association between heart attack-induced PTSD and sleep may be due to the fact that disturbed sleep is a standard characteristic of PTSD.

Although PTSD and sleep disturbance may occur at the same time, one may not be a symptom of the other, according to Dr. Shaffer and his team.

While the American Heart Association reports that major studies have shown correlations between sleep disorders and atrial fibrillation, hypertension and pulmonary hypertension, further research is needed to better understand the associations of PTSD due to heart attack, poor sleep, and risk for future heart attacks.

The study was published in May in the Annals of Behavioral Medicine. This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH).

Review Date: 
June 1, 2013