Zeev N Kain1, Alison A Caldwell-Andrews. 1. Department of Anesthesiology, Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA. kain@biomed.med.yale.edu
Abstract
STUDY OBJECTIVE: To describe sleeping patterns of adults before and after outpatient surgery. DESIGN: Observational cohort study. SETTING: Outpatient surgical facility. PATIENTS: 127 consenting adults, including 92 surgery patients and 35 community controls. INTERVENTIONS: Participants' sleep was measured for two days before and 2 days after outpatient surgery. MEASUREMENTS: Sleep was measured using actigraphy; additional measurements were made of anxiety (STAI), pain and energy (VAS), recovery (PHRI), and sleep history. MAIN RESULTS: Approximately 23% of patients experienced clinically significant sleep impairment after surgery, a more difficult recovery, increased pain, and lower energy. In contrast, only 2.9% of the community control group experienced clinically significant sleep impairment during the same time period. Also, patients in the surgery group experienced significantly more True Wake Time postoperatively than did control patients (p = 0.029). The surgery group also experienced more Night Awakenings >5 minutes than the control group (p = 0.006), but not more overall Night Awakenings (p = 0.106). Finally, of the patients in the surgery group, those who had higher state anxiety in the holding area also had more difficulty sleeping over the 4-day monitoring period (True Sleep Time was lower, 352 +/- 187 vs. 229 +/- 225, p = 0.009). CONCLUSIONS: A moderate proportion of adults experience postoperative sleeping problems.
STUDY OBJECTIVE: To describe sleeping patterns of adults before and after outpatient surgery. DESIGN: Observational cohort study. SETTING:Outpatient surgical facility. PATIENTS: 127 consenting adults, including 92 surgery patients and 35 community controls. INTERVENTIONS:Participants' sleep was measured for two days before and 2 days after outpatient surgery. MEASUREMENTS: Sleep was measured using actigraphy; additional measurements were made of anxiety (STAI), pain and energy (VAS), recovery (PHRI), and sleep history. MAIN RESULTS: Approximately 23% of patients experienced clinically significant sleep impairment after surgery, a more difficult recovery, increased pain, and lower energy. In contrast, only 2.9% of the community control group experienced clinically significant sleep impairment during the same time period. Also, patients in the surgery group experienced significantly more True Wake Time postoperatively than did control patients (p = 0.029). The surgery group also experienced more Night Awakenings >5 minutes than the control group (p = 0.006), but not more overall Night Awakenings (p = 0.106). Finally, of the patients in the surgery group, those who had higher state anxiety in the holding area also had more difficulty sleeping over the 4-day monitoring period (True Sleep Time was lower, 352 +/- 187 vs. 229 +/- 225, p = 0.009). CONCLUSIONS: A moderate proportion of adults experience postoperative sleeping problems.
Authors: Caroline E Wright; Dana H Bovbjerg; Guy H Montgomery; Christina Weltz; Alisan Goldfarb; Benjamin Pace; Jeffrey H Silverstein Journal: J Pain Symptom Manage Date: 2008-08-23 Impact factor: 3.612