Interaction effects between sleep disorders and depression on heart failure

Abstract

Background: Sleep disorders and depression were recognized as independent risk factors for heart failure, whether their interaction effects also correlated with the risk of heart failure remains elusive. This study was to explore the interaction effects between sleep disorders and depression on the risk of heart failure. Methods: This was a cross-sectional study that included data from 39,636 participants in the National Health and Nutritional Examination Survey (NHANES) database. Poisson regression model was applied to evaluate the associations of depression or sleep disorders with heart failure. The relative excess risk of interaction (RERI), attributable proportion of interaction (API) and synergy index (SI) were used to measure whether the interaction effects between depression and sleep disorders on heart failure was statistically significant. Results: The risk of heart failure was increased in people with sleep disorders [risk ratio (RR) = 1.92, 95% confidence interval (CI): 1.68–2.19) after adjusting for confounders including age, gender, body mass index (BMI), race, marital status, education level, annual family income, drinking history, smoking history, diabetes, hypertension and stroke. The risk of heart failure was elevated in patients with depression after adjusting for confounders (RR = 1.96, 95%CI: 1.65–2.33). Patients with depression and sleep disorders were associated with increased risk of heart failure after adjusting for confounders (RR = 2.76, 95%CI: 2.23–3.42). The CIs of interactive indexes RERI was -0.42 (95%CI: -1.23–0.39), and API was -0.15 (95%CI: -0.46–0.16), which included 0. The CI of interactive indexes SI was 0.81 (95%CI: 0.54–1.21), which contained 1. Conclusion: Depression and sleep disorders were independent risk factors for heart failure but the interaction effects between depression and sleep disorders on the occurrence of heart failure were not statistically different.