Association of sleep disturbances within 4 weeks prior to incident acute myocardial infarction and long-term survival in male and female patients: an observational study from the MONICA/KORA Myocardial Infarction Registry

Table 2 Association of frequency of sleep disturbances within 4 weeks prior to AMI (categorization 1) and long-term mortality in male and female patients

		Men (n = 2511; 318 deaths)			Women (n = 828; 131 deaths)
		HR	[95% CI]	p-value^a	HR	[95% CI]	p-value^a
	Frequency of sleep disturbances
Unadjusted model	never	1	Ref.	0.0024	1	Ref.	0.9686
	sometimes	1.58	[1.23–2.03]		1.00	[0.67–1.49]
	nightly	1.00	[0.66–1.52]		0.94	[0.59–1.51]
Age-adjusted model	never	1	Ref.	0.0032	1	Ref.	0.9773
	sometimes	1.56	[1.21–2.00]		0.97	[0.65–1.44]
	nightly	1.00	[0.66–1.51]		0.96	[0.60–1.53]
Model Lifestyle^b	never	1	Ref.	0.0038	1	Ref.	0.9665
	sometimes	1.55	[1.20–1.99]		0.96	[0.64–1.43]
	nightly	0.99	[0.65–1.50]		0.95	[0.59–1.52]
Model Comorbidities^c	never	1	Ref.	0.0060	1	Ref.	0.9556
	sometimes	1.50	[1.16–1.93]		0.98	[0.66–1.47]
	nightly	0.92	[0.60–1.39]		0.93	[0.58–1.49]
Model Clinical^d	never	1	Ref.	0.0150	1	Ref.	0.9899
	sometimes	1.47	[1.14–1.89]		0.97	[0.65–1.46]
	nightly	1.02	[0.67–1.54]		0.97	[0.61–1.57]
Full model^e	never	1	Ref.	0.0370	1	Ref.	0.9055
	sometimes	1.40	[1.08–1.81]		0.99	[0.66–1.49]
	nightly	0.95	[0.62–1.45]		0.90	[0.55–1.46]

AMI = acute myocardial infarction, CI = confidence interval, HR = Hazard Ratio
^ap-value obtained from Likelihood-Ratio test for overall significance of 3-categorical variable ‘frequency of sleep disturbances’ in the respective model
^bMEN: adjusted for age (cont.), married, low education (< 9 years), employment status, smoking ever and BMI (cont)
WOMEN: adjusted for age (cont.), married and employment status
^cMEN: adjusted for age (cont.), hypertension, angina, diabetes, dyslipidemia and stroke
WOMEN: adjusted for age, diabetes and stroke
^dMEN: adjusted for age (cont.), type of infarction, any revascularization treatment (coronary artery bypass surgery, percutaneous coronary intervention (PCI) with/without stenting, or thrombolysis), all four evidence based medications at discharge (antiplatelet agents, beta-blockers, ACEIs/ARBs (Angiotensin-converting enzyme inhibitors/Angiotensin receptor blockers), statins) and year of MI
WOMEN: adjusted for age (cont.), type of infarction, any revascularization treatment and all four evidence based medications at discharge
^eMEN AND WOMEN: adjusted for age (cont.), low education (< 9 years), married, employment status, ever smoking, BMI (cont.), hypertension, angina, diabetes, dyslipidemia, stroke, type of infarction, any revascularization treatment, all four evidence based medications at discharge and year of MI

ISSN: 1471-2261