0990 Is There an Association Between Poor Sleep Patterns and the Occurrence of Minor Adverse Events During Exercise in Cardiac Rehabilitation Programs?

Abstract Introduction Sleep assessment has been recommended as part of risk stratification and management of patients enrolled in cardiac rehabilitation programs (CRP). Poor sleep patterns have been associated with unfavorable outcomes. However, the relationship between sleep characteristics in CRP participants and the occurrence of complications during exercise remains unclear. Although CRP is considered safe, patients can experience minor events, such as angina. These episodes reflect exercise intolerance and could signal an increased risk of major cardiac events, for example, myocardial infarction. Understanding these connections may help guide exercise prescription and monitoring strategies, and improve patient safety. This study aimed to investigate whether there is a relationship between the sleep patterns of CRP patients and the appearance of minor events during exercise. Methods Ethical approval was granted (CAAE: 35831220.8.0000.5402). Individuals from CRP were included in the study. Volunteers wore a triaxial accelerometer on their non-dominant wrist for 7 days to assess sleep. Raw accelerometer data was processed using the GGIR package in R, and analyses were performed only for individuals with at least 5 valid days (≥16 hours/day). Sleep parameters of interest were sleep duration, sleep efficiency and wake after sleep onset (WASO). Minor events (angina, cramp, dizziness, increased systolic (>200mmHg) and/or diastolic (>120mmHg) blood pressure during exercise, fatigue, muscle pain, nausea and pallor) were recorded across 24 exercise sessions by trained therapists. Overdispersed Poisson regression was used, considering ≥6 hours of sleep, WASO ≤40 minutes, and sleep efficiency ≥85% as reference categories. Results The sample was composed of 89 participants (69.71±9.92 years). No significant associations were found between sleep duration (IRR=0.555 [95%CI=0.272-1.08]; p=0.09), WASO (IRR=1.13 [95%CI=0.458-3.59]; p=0.81) and sleep efficiency (IRR=0.578 [95%CI=0.257-1.19]; p=0.16) with events during exercise. Conclusion Poor sleep patterns were not related to the manifestation of minor events during exercise in CRP. Despite these findings, sleep screening remains essential, as inadequate sleep is linked with worse outcomes in individuals with cardiovascular disease, including mortality and recurrent cardiac events. Research employing additional assessment methods is warranted. Support (if any) HBV and MLA are supported by FAPESP (#2023/11651-4; #2020/13467-8). PKM is supported by AFIP, and RMSS by CAPES. FLP, MLA, DGDC, ST, and LCM are CNPq fellowship recipients.