Sleep is an important component of cardiovascular health, yet insomnia often remains underrecognized in patients with coronary heart disease (CHD). A meta-analysis published in Frontiers in Psychiatry evaluated the prevalence of insomnia and factors associated with higher odds of the condition in patients with CHD.

A systematic search of ten databases from inception to 7 September 2025 identified 19 eligible studies involving 5,928 patients with CHD. The analysis extracted pooled prevalence estimates, odds ratios (ORs), and 95% confidence intervals (CIs). Statistical testing included subgroup analyses, meta-regression, and sensitivity analyses.

The pooled prevalence of insomnia among patients with CHD was 51.8% (95% CI: 44.6%–59.0%; P < .001), indicating that more than half of this population reported insomnia. Factors associated with higher odds of insomnia included female sex (OR 2.00; 95% CI: 1.58-2.52; P < .001), anxiety (OR 1.61; 95% CI: 1.36-1.91; P < .001), depression (OR 2.15; 95% CI: 1.48-3.13; P < .001), CHD duration of at least 3 years (OR 1.73; 95% CI: 1.25-2.40; P = .001), diabetes (OR 1.50; 95% CI: 1.45-1.56; P < .001), and gastritis (OR 2.24; 95% CI: 1.62-3.11; P < .001).

The findings identify insomnia as a common comorbidity in patients with CHD and support greater clinical attention to sleep symptoms, particularly in those with multiple associated conditions.