Christine Hedges1, Nancy S Redeker. 1. Ann May Center for Nursing, Meridian Health, Jersey Shore University Medical Center, Neptune, NJ 07754, USA. chedges@meridianhealth.com
Abstract
BACKGROUND: Off-pump coronary artery bypass surgical procedures have been advocated to reduce the adverse effects of cardiopulmonary bypass on the brain. OBJECTIVE: To examine differences in objective and subjective characteristics of sleep and mood disturbance between patients after on-pump and off-pump coronary artery bypass surgery. METHODS: In a secondary analysis of pooled data from 2 previous studies, sleep characteristics and mood disturbance on postoperative night 2 after transfer to the cardiac surgery step-down unit were compared in patients who had on-pump and off-pump cardiac surgery. The sample included 129 coronary artery bypass patients: 48 on-pump patients from one hospital and 81 off-pump patients from another hospital. Data were obtained with wrist actigraphs. Subjective characteristics of sleep were determined by using the Pittsburgh Sleep Quality Index and a sleep diary; mood disturbance was evaluated by using the short form of the Profile of Mood States. RESULTS: Off-pump surgery was associated with better objective sleep continuity (decreased percentage of wake time after sleep onset and fewer awakenings) but not longer sleep duration after controlling for age and sex. The 2 groups of patients did not differ overall in subjective sleep characteristics, mood disturbance, or preoperative sleep quality. CONCLUSION: Use of off-pump coronary artery bypass surgery may improve sleep continuity during the early postoperative period. Prospective longitudinal studies are needed to evaluate the potential long-term benefits of this procedure during the different phases of recovery.
BACKGROUND: Off-pump coronary artery bypass surgical procedures have been advocated to reduce the adverse effects of cardiopulmonary bypass on the brain. OBJECTIVE: To examine differences in objective and subjective characteristics of sleep and mood disturbance between patients after on-pump and off-pump coronary artery bypass surgery. METHODS: In a secondary analysis of pooled data from 2 previous studies, sleep characteristics and mood disturbance on postoperative night 2 after transfer to the cardiac surgery step-down unit were compared in patients who had on-pump and off-pump cardiac surgery. The sample included 129 coronary artery bypass patients: 48 on-pump patients from one hospital and 81 off-pump patients from another hospital. Data were obtained with wrist actigraphs. Subjective characteristics of sleep were determined by using the Pittsburgh Sleep Quality Index and a sleep diary; mood disturbance was evaluated by using the short form of the Profile of Mood States. RESULTS: Off-pump surgery was associated with better objective sleep continuity (decreased percentage of wake time after sleep onset and fewer awakenings) but not longer sleep duration after controlling for age and sex. The 2 groups of patients did not differ overall in subjective sleep characteristics, mood disturbance, or preoperative sleep quality. CONCLUSION: Use of off-pump coronary artery bypass surgery may improve sleep continuity during the early postoperative period. Prospective longitudinal studies are needed to evaluate the potential long-term benefits of this procedure during the different phases of recovery.