Clinical depression is a risk factor for mortality and morbidity after acute myocardial infarction (MI), yet little is known about the underlying mechanisms that account for this. The purpose of this study is to examine a potential mechanism, cardiovascular response to disordered sleep. Three months after an MI, 75 patients who meet the DSM-IV criteria for major depression will be selected and matched for gender, age, BMI to patients without depression. Polysomnography will be performed to determine the frequency and severity of cardiac responses to sleep disordered breathing and sleep architecture measures. The following hypotheses will be tested: 1) patients with depression have greater cardiac response to episodes of sleep apnea than non-depressed patients; 2) patients with depression without sleep disordered breathing have shorter REM latency, increased REM density, reduced slow wave sleep and worse sleep efficiency; 3) increased cardiac response to sleep disordered breathing, a shorter REM latency, increased REM density, decreased slow wave sleep are associated with electro cardio-graphic abnormalities predictive of cardiac events in post MI patients.
| Carney, Robert M; Freedland, Kenneth E; Duntley, Stephen P et al. (2011) Obstructive sleep apnea and major depressive disorder in cardiovascular disease. Int J Cardiol 149:283-284 |
| Carney, Robert M; Freedland, Kenneth E; Stein, Phyllis K et al. (2007) Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease. J Psychosom Res 62:463-7 |
| Wells, Rachel D; Freedland, Kenneth E; Carney, Robert M et al. (2007) Adherence, reports of benefits, and depression among patients treated with continuous positive airway pressure. Psychosom Med 69:449-54 |
| Stein, Phyllis K; Lundequam, Eric J; Oliveira, Leonardo P J et al. (2007) Cardiac autonomic modulation. Analyzing circadian and ultradian rhythms. IEEE Eng Med Biol Mag 26:14-8 |
| Carney, Robert M; Howells, William B; Freedland, Kenneth E et al. (2006) Depression and obstructive sleep apnea in patients with coronary heart disease. Psychosom Med 68:443-8 |
| Stein, Phyllis K; Domitrovich, Peter P; Lundequam, Eric J et al. (2006) Circadian and ultradian rhythms in heart rate variability. Biomed Tech (Berl) 51:155-8 |
| Stein, Phyllis K; Lundequam, Eric J; Clauw, Daniel et al. (2006) Circadian and ultradian rhythms in cardiac autonomic modulation. Conf Proc IEEE Eng Med Biol Soc 1:429-32 |
| Carney, Robert M; Freedland, Kenneth E (2003) Depression, mortality, and medical morbidity in patients with coronary heart disease. Biol Psychiatry 54:241-7 |
| Carney, Robert M; Freedland, Kenneth E (2002) Psychological distress as a risk factor for stroke-related mortality. Stroke 33:5-6 |
| Carney, Robert M; Freedland, Kenneth E; Miller, Gregory E et al. (2002) Depression as a risk factor for cardiac mortality and morbidity: a review of potential mechanisms. J Psychosom Res 53:897-902 |
