Identifying sleep profiles in patients with an implantable cardioverter-defibrillator: associations with psychological distress.

BACKGROUND

Sleep disturbances are highly prevalent and associated with greater psychological symptom burden in patients with implantable cardioverter-defibrillators (ICDs), yet the multidimensional nature of sleep disturbance in this population remains insufficiently characterized.

OBJECTIVES

This study aimed to (1) identify distinct sleep patterns in patients with an ICD using the seven Pittsburgh Sleep Quality Index (PSQI) component scores, (2) examine sociodemographic and clinical predictors of sleep-profile membership, and (3) assess associations between sleep profiles and symptom burden of posttraumatic stress, anxiety, and depression.

METHODS

Sleep profiles were derived from PSQI component scores using latent profile analysis (LPA). Sociodemographic and clinical determinants of profile membership were evaluated using multinomial logistic regression. Associations between sleep profiles and posttraumatic stress, anxiety, and depression symptom severity were examined using linear regression, assessed using the Posttraumatic Diagnostic Scale (PDS), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-8 (PHQ-8).

RESULTS

Four sleep profiles were identified: Best sleep (mean 35.9%), Intermediate sleep (mean 38.2%), Worst sleep (mean 13.1%), and Medicated sleep (mean 12.8%) of participants across imputed datasets. Compared with the Best sleep profile, all other profiles exhibited significantly higher PDS, GAD-7, and PHQ-8 scores. Sociodemographic and clinical variables were not associated with sleep-profile membership in multinomial models.

CONCLUSIONS

ICD patients demonstrate heterogeneous subjective sleep profiles that are differentially associated with posttraumatic stress, anxiety, and depression symptom severity. These findings highlight the relevance of considering multiple dimensions of subjective sleep disturbance in ICD patients and may help characterize patients at elevated risk for psychological symptoms.