# Patterns of Sleep Quality and Their Associations With Depressive and Anxiety Symptoms Among Chinese Coronary Heart Disease Patients: A Latent Class Analysis

## TL;DR

This study found that poor sleep patterns in Chinese coronary heart disease patients are linked to higher risks of depression and anxiety, suggesting improving sleep could help mental health.

## Contribution

The study identifies distinct sleep quality patterns and their specific associations with depressive and anxiety symptoms in CHD patients using latent class analysis.

## Key findings

- Four sleep quality patterns were identified, with 'Poor sleep' and 'Disturbed sleep' groups showing the strongest links to depression and anxiety.
- Improving sleep quality may be an effective strategy to reduce mental health symptoms in coronary heart disease patients.
- The associations between sleep patterns and mental health symptoms remained significant after adjusting for confounders.

## Abstract

Sleep problem among coronary heart disease (CHD) patients has emerged as a pressing health problem. This study aimed to explore different sleep quality patterns and their associations with depressive and anxiety symptoms among CHD patients.

This study included 691 CHD patients from China and was conducted in 2023. Basic demographic characteristics, sleep quality, depressive, and anxiety symptoms were collected. Latent class analysis (LCA) and binary logistic regression analysis were conducted to identify sleep quality patterns and to explore the associations between these patterns and symptoms of depression and anxiety.

Among the patients, 62.81% reported depressive symptoms and 48.48% had anxiety symptoms. Four sleep quality patterns were identified: “Good sleep group” (55.57%), “Inefficient short sleep group” (14.33%), “Poor sleep group” (8.68%), and “Disturbed sleep group” (21.42%). Compared to the “Good sleep group,” both “Disturbed sleep group” (OR = 4.39, 95% CI: 2.76–6.97) and “Poor sleep group” (OR = 3.92, 95% CI: 2.02–7.61) exhibited high depressive symptoms, with “Inefficient short sleep group” also showing increased depressive symptoms (OR = 2.48, 95% CI: 1.54–4.02). For anxiety symptoms, “Poor sleep group” (OR = 2.90, 95% CI: 1.64–5.12), “Disturbed sleep group” (OR = 2.35, 95% CI: 1.60–3.47), and “Inefficient short sleep group” (OR = 2.12, 95% CI: 1.35–3.31) all exhibited elevated levels of anxiety symptoms. These associations remained robust after adjusting for potential confounders.

This study highlights the critical role of sleep quality in the mental health of CHD patients, identifying specific sleep quality patterns associated with higher risks of depressive and anxiety symptoms. Improving sleep quality may serve as an effective approach to alleviating these mental health symptoms, offering valuable insights for targeted interventions to enhance well-being of CHD patients.