An observational study: The relationship between sleep quality and angiographic progression in patients with chronic coronary artery disease

Background and aims: Previous studies reported that sleeping disorders were associated with presence and severity of coronary artery disease (CAD). We aimed to evaluate the relationship between the angiographic progression of CAD with sleep quality. Methods: We enrolled 690 patients who had angiography history with diagnosis of chronic CAD, requiring new angiography according to clinical, and laboratory evaluation among 1654 patients with complaint of stable angina. Previous and new coronary angiography images of patients were compared to evaluate the presence of angiographic progression using quantitative coronary analysis measurement. A 1:2 propensity score matching was performed. Thus, the patient population was divided into two groups including non-progressors group (n = 156) and progressors group (n = 78). Groups were compared in terms of sleep quality and disorder using Pittsburgh Sleep Quality Index (PSQI) and STOP -Bang questionnaire. Results: Progressors had shorter sleep duration, higher PSQI score indicating poorer sleep quality and higher STOP BANG score indicating increased sleep apnea risk than non-progressors (p < 0.05). The multivariate logistic regression analysis determined that night shift work (OR: 1.38, p = 0.04), sleep duration difference (OR: 1.25, p = 0.03), poorer sleep quality (OR: 2.08, p = 0.01), high STOP BANG score (OR: 1.86, p = 0.004), and high risk of sleep apnea (OR: 3.84, p = 0.008) were independently associated with significant risk of angiographic CAD progression. Conclusion: Our findings suggested that angiographically proven chronic CAD progression was associated with poor sleep quality including high apnea risk. Selected patients should be subjected to an advanced evaluation including sleep study to diagnose sleep disorders such as sleep apnea. Treatment of sleep disorders can support existing medical and/or invasive treatments in chronic CAD and improve outcomes.