Sleep Disturbances in Patients With Coronary Heart Disease: A Systematic Review

Michael Tilling Madsen, Chenxi Huang, Graziella Zangger, Ann Dorthe Olsen Zwisler, Ismail Gögenur

Research output: Contribution to journalJournal articleResearchpeer-review


STUDY OBJECTIVES: Investigation into sleep and coronary heart disease (CHD) has predominantly been focused on sleep disturbances as a risk factor for developing CHD. Objectively measured and self-reported sleep at a patient level has only been sparsely and not systematically reported. Therefore, we set out to review the literature for studies using objectively measured and self-reported sleep in patients with CHD. The review focuses on patients with acute coronary syndrome (ACS) and stable CHD. METHODS: A systematic review performed in four databases adhering to the PRISMA guidelines applying a qualitative synthesis of evidence. RESULTS: Following ACS, we found sleep architecture to be significantly disturbed with changes normalizing over a period of up to 6 months. With increasing severity of CHD, sleep disturbances were more pronounced; however, the modulating effects of sleep-disordered breathing and ejection fraction on sleep in patients with CHD are conflicting. Overall, studies were predominantly cross-sectional in design and of low methodological quality. Polysomnography was the predominant outcome assessment tool and validated self-reported assessment tools were limited. CONCLUSIONS: Future investigations in sleep and CHD applying both a longitudinal design and investigating objective and self-reported sleep assessments are warranted. SYSTEMATIC REVIEW REGISTRATION: Registry: PROSPERO, Title: Sleep measures in relation to coronary heart disease: a systematic review, Identifier: CRD42017056377, URL:

Original languageEnglish
JournalJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
Issue number3
Pages (from-to)489-504
Publication statusPublished - 15. Mar 2019


  • actigraphy
  • acute coronary syndrome
  • coronary heart disease
  • insomnia severity index
  • Pittsburgh Sleep Quality Index
  • polysomnography
  • Actigraphy
  • Insomnia severity index
  • Acute coronary syndrome
  • Polysomnography
  • Coronary heart disease


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