Anger Expression and Sleep Quality in Patients With Coronary Heart Disease: Findings From the Heart and Soul Study

Caska, Catherine M.; Hendrickson, Bethany E.; Wong, Michelle; Ali, Sadia; Neylan, Thomas C.; Whooley, Mary A.

doi:10.1097/psy.0b013e31819b6a08

Cited by 51 publications

(34 citation statements)

References 64 publications

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“…However, we note that insomnia is currently defined based on self-report, 50 and that single-item measures of sleep and physical activity have previously been associated with important psychological and medical outcomes. 4,39 In particular, self-reported measures of sleep and physical activity have been predictors of metabolic syndrome 15 and cardiovascular events 4 in previous studies. Nonetheless, we recommend that future research include longer and/or more frequent subjective assessments as well as objective assessments to examine physiological correlates of sleep quality and physical activity (i.e., objective measurement of fitness).…”

Section: Discussionmentioning

confidence: 99%

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The Mediating Effect of Sleep Quality on the Relationship between PTSD and Physical Activity

Talbot

Neylan

Metzler

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: Physical inactivity is linked to health outcomes such as obesity, diabetes, and psychiatric disorders. Sleep disturbance has been linked to the same adverse outcomes. We examine the infl uence of sleep on physical activity as a novel approach to understand these relationships. Specifi cally, our objective was to determine whether low sleep quality predicts low physical activity in posttraumatic stress disorder (PTSD), a disorder associated with sleep disturbance, physical inactivity, and poor health outcomes. Methods: We used data from the Mind Your Heart Study, a prospective cohort study of 736 outpatients recruited from two Department of Veterans Affairs (VA) medical centers. We assessed PTSD with the Clinician Administered PTSD Scale, sleep quality using an item from the Pittsburgh Sleep Quality Index, and physical activity by self-report at baseline and again one year later. Hierarchical multiple regression models and structural equation modeling were used to examine the relationships among PTSD, sleep, and physical activity. Results: Sleep quality but not PTSD status was prospectively associated with lower physical activity in a model adjusting for age, sex, apnea probability, depression, body mass index, and baseline physical activity (β = 0.129, SE = 0.072, p < 0.01). Structural equation modeling indicated that the results were consistent with sleep quality statistically mediating the relationship between PTSD status at baseline and physical activity one year later. Conclusions: Worse sleep quality predicts lower physical activity in PTSD, providing possible evidence for a behavioral pathway from disturbed sleep to poor physical health outcomes. Keywords: posttraumatic stress disorder, sleep quality, physical activity Citation: Talbot LS, Neylan TC, Metzler TJ, Cohen BE. The mediating effect of sleep quality on the relationship between PTSD and physical activity. J Clin Sleep Med 2014;10(7):795-801.

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Section: Discussionmentioning

confidence: 99%

“…37 A question assessing sleep quality has been recommended as essential when assessing sleep by self-report, 38 and the particular sleep quality question used in the present study has previously predicted outcomes such as anger expression. 39 …”

Section: Sleepmentioning

confidence: 99%

The Mediating Effect of Sleep Quality on the Relationship between PTSD and Physical Activity

Talbot

Neylan

Metzler

et al. 2014

Journal of Clinical Sleep Medicine

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“…In addition, suppressed anger has also been identified as a contributing factor in poor sleep quality among patients with coronary heart disease. 30 Perhaps more so than other psychosocial factors, the role of anger and hostility among women appears to be different for men and women. In a review of psychosocial factors in the development of CHD in women, Low and colleagues 31 identified that hostility was less consistently associated with CHD among women as opposed to men.…”

Section: Anxietymentioning

confidence: 99%

Importance of psychosocial status in secondary prevention and rehabilitation of coronary artery disease

McCormick¹

2011

Srce i krvni sudovi

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Introduction The rehabilitation and secondary prevention of coronary heart disease (CHD) has increasingly acknowledged the effect of psychosocial factors in disease progression. Although psychosocial factors have been recognized as relevant to cardiac rehabilitation for over 30 years, 1 calls for greater attention to psychosocial status in CHD onset and rehabilitation only began appearing in professional literature in the mid to late 1990s. 2,3 At present knowledge of psychosocial factors in CHD are considered core competencies for all professionals working in cardiac rehabilitation and secondary prevention. 4 This paper reviews recent research in psychosocial risk factors for CHD as well as implications for rehabilitation and secondary prevention. In addition, motivation and readiness for change are reviewed as a critical consideration in behavioral change as part of both rehabilitation and secondary prevention. Psychosocial risk factors LifestyleLifestyle and behavior represent one of the most directly modifiable factors in secondary prevention of CHD. 5Principal among these risk factors are elevated cholesterol and triglycerides, obesity, high blood pressure, smoking, diabetes and sedentary behavior, and current guidelines for secondary prevention suggest treatment in all areas.6 Although these risk factors are appropriately considered as biophysical factors, there is evidence that changes in these biophysical factors may positively affect psychosocial status. For example, even mild improvements in physical fitness have been found to be effective in reducing depression and subsequent mortality 6 in cardiac rehabilitation. 7,8 In addition, secondary prevention programs targeting reductions in body mass index (BMI) have also been shown to be effective in reducing depression, improving social functioning and improving emotional functioning. 9, 10Depression Depression remains as one of the most significant psychosocial risk factors in secondary prevention and cardiac rehabilitation. Depression is implicated in both the onset of CHD as well as the prognosis in rehabilitation.11 Although estimates vary, depression confers a relative risk of onset of CHD in the range of 1.5-2.0 in initially healthy individuals.11 Among those diagnosed with CHD, rates of clinically significant depression has been identified in 15-20% of heart failure patients. 12,13 Depression is also clinically significant for its role in cardiac rehabilitation. Cardiac patients diagnosed with depression demonstrate poorer adherence to cardiac rehabilitation regimen, and increased odds of non-completion.14, 15 It is worth noting that although there is not strong research evidence, preliminary indications are that the somatic symptoms of depression such as fatigue, sleep disturbance and appetite disturbance have a greater effect on compliance and completion 15 as well as subsequent cardiac events. 16Lifestyle and behavioral factors play a major part in the development of coronary heart disease (CHD). Rehabilitation and secondary prevention of CHD mus...

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“…((1) very bad to (5) very good), thereby, providing self-report measures of time in bed, duration, sleep onset latency, and sleep quality, respectively. These single-item sleep measures are common in epidemiologic studies and have been linked to a variety of negative health outcomes [24][25][26][27]. Finally, participants were asked if their sleep patterns over the past week represent their typical sleep pattern over the past 3 months (typical versus atypical).…”

Section: Sleep Measuresmentioning

confidence: 99%

Assessing the scholarly impact of health psychology: A citation analysis of articles published from 1993 to 2003.

Frosch¹,

Saxbe²,

Tomiyama³

et al. 2010

Health Psychology

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Background. Accumulating evidence supports leukocyte telomere length (LTL) as a biological marker of cellular aging. Poor sleep is a risk factor for age-related disease; however, the extent to which sleep accounts for variation in LTL is unknown. Methods. The present study examined associations of self-reported sleep duration, onset latency, and subjective quality with LTL in a communitydwelling sample of 245 healthy women in midlife (aged 49-66 years). Results. While sleep duration and onset latency were unrelated to LTL, women reporting poorer sleep quality displayed shorter LTL (r = 0.14, P = 0.03), independent of age, BMI, race, and income (b = 55.48, SE = 27.43, P = 0.04). When analyses were restricted to participants for whom sleep patterns were chronic, poorer sleep quality predicted shorter LTL independent of covariates and perceived psychological stress. Conclusions. This study provides the first evidence that poor sleep quality explains significant variation in LTL, a marker of cellular aging.

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Anger Expression and Sleep Quality in Patients With Coronary Heart Disease: Findings From the Heart and Soul Study

Cited by 51 publications

References 64 publications

The Mediating Effect of Sleep Quality on the Relationship between PTSD and Physical Activity

The Mediating Effect of Sleep Quality on the Relationship between PTSD and Physical Activity

Importance of psychosocial status in secondary prevention and rehabilitation of coronary artery disease

Assessing the scholarly impact of health psychology: A citation analysis of articles published from 1993 to 2003.

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