ARE SLEEP COMPLAINTS AN INDEPENDENT RISK FACTOR FOR MYOCARDIAL-INFARCTION

PURPOSE: To investigate whether subjective sleep complaints are an ind ependent predictor of myocardial infarction (MI) in a community of old er adults and to gain clues as to why the association between sleep co mplaints and incident MI exists. METHODS: Using longitudinal data from the Piedmont study on 2960 adults aged 65 or older who were free of s ymptomatic heart disease at baseline, we screened 19 potential confoun ders to determine if any, alone or in combination, could explain the o bserved relationship between incident MI and sleep complaints. RESULTS : During the three-year follow-up period, there were 152 incident MIs. Restless sleep (incidence density ratio (IDR) = 1.58, 95% confidence interval (CI) = 1.11, 2.24) and trouble falling asleep (IDR = 1.68, 95 % CI 1.09, 2.60) predicted incident MI after adjusting for age, Sender , and race. IDRs were not substantially impacted by controlling for sm oking, blood pressure, diabetes or obesity. After adjustment for educa tion, number of prescription medicines, self-rated health, and depress ion score, all IDRs were nullified. In particular, self-rated health a nd depression were strong independent risk factors for MI. CONCLUSIONS : A subjective sleep complaint increases the likelihood of a first MI in older adults without overt coronary heart disease (CHD) independent ly of classic coronary risk factors and appears to be a marker for a s yndrome of depression and malaise that may have a causal relationship to MI. (C) 1998 Elsevier Science Inc.