Insomnia symptoms in women and men after percutaneous coronary intervention – a prospective multicentre cohort study

AIMS: Insomnia is an independent risk factor for coronary artery disease (CAD). Persistent sleep difficulties after percutaneous coronary intervention (PCI) may hinder recovery, however, studies investigating factors contributing to insomnia in a longitudinal perspective are scarce. Therefore, we aimed to describe and determine: (i) the prevalence of insomnia symptoms in women and men with CAD after PCI; (ii) changes in insomnia symptoms scores over time and (iii) the association between insomnia symptoms, self-reported health status and individual factors 2-, 6- and 12 months post-PCI. METHODS AND RESULTS: Large-scale, prospective, multicentre cohort study on patients after PCI (N = 3,417). Patient-reported outcomes for all included patients were collected during index hospitalization after PCI prior to hospital discharge and 2-, 6-, and 12-months post-PCI (T0-T3 respectively). Insomnia symptoms were assessed with the Minimal Insomnia Symptom Scale, and self-reported health status with RAND-12 and the Seattle Angina Questionnaire. Clinical characteristics were collected from The Norwegian Registry of Invasive Cardiology and patients' medical records. The prevalence of insomnia symptoms was high (women 47% vs. men 28%) at T0 (p < 0.001) and remained at similar levels (T1-T3). Reduced mental health in men (p < 0.001, T1, T2 and T3) and women (p = 0.002 (T1), p = 0.005 (T2) and p = 0.040 (T3)) and physical health in women (p = 0.032 (T2) and p = 0.016 (T3)) were significantly associated with more severe insomnia symptoms. Moreover, insomnia symptoms at previous timepoints were associated with insomnia symptoms at later timepoints for both sexes (p < 0.001 for all comparisons). CONCLUSION: Insomnia symptoms are highly prevalent following PCI, particularly among women, persisting over time, and related to poorer mental health in men and women. Greater attention should be directed toward early screening and targeted sleep interventions in both sexes.