William J Kane1, Taryn E Hassinger1, David L Chu2, Emma L Myers3, Ashley N Charles1, Sook C Hoang1, Charles M Friel1, Robert H Thiele4, Eric M Davis5, Traci L Hedrick6. 1. Department of Surgery, University of Virginia Health System, Charlottesville, USA. 2. School of Medicine, University of Virginia, Charlottesville, USA. 3. The College of Arts and Sciences, University of Virginia, Charlottesville, USA. 4. Department of Anesthesiology, University of Virginia Health System, Charlottesville, USA. 5. Department of Medicine, University of Virginia Health System, Charlottesville, USA. 6. Department of Surgery, University of Virginia Health System, Charlottesville, USA. th8q@hscmail.mcc.virginia.edu.
Abstract
BACKGROUND: While total sleep duration and rapid eye movement (REM) sleep duration have been associated with long-term mortality in non-surgical cohorts, the impact of preoperative sleep on postoperative outcomes has not been well studied. METHODS: In this secondary analysis of a prospective observational cohort study, patients who recorded at least 1 sleep episode using a consumer wearable device in the 7 days before elective colorectal surgery were included. 30-day postoperative outcomes among those who did and did not receive at least 6 h of total sleep, as well as those who did and did not receive at least 1 h of rapid eye movement (REM) sleep, were compared. RESULTS: 34 out of 95 (35.8%) patients averaged at least 6 h of sleep per night, while 44 out of 82 (53.7%) averaged 1 h or more of REM sleep. Patients who slept less than 6 h had similar postoperative outcomes compared to those who slept 6 h or more. Patients who averaged less than 1 h of REM sleep, compared to those who achieved 1 h or more of REM sleep, had significantly higher rates of complication development (29.0% vs. 9.1%, P = 0.02), and return to the OR (10.5% vs. 0%, P = 0.04). After adjustment for confounding factors, increased REM sleep duration remained significantly associated with decreased complication development (increase in REM sleep from 50 to 60 min: OR 0.72, P = 0.009; REM sleep ≥ 1 h: OR 0.22, P = 0.03). CONCLUSION: In this cohort of patients undergoing elective colorectal surgery, those who developed a complication within 30 days were less likely to average at least 1 h of REM sleep in the week before surgery than those who did not develop a complication. Preoperative REM sleep duration may represent a risk factor for surgical complications; however additional research is necessary to confirm this relationship.
BACKGROUND: While total sleep duration and rapid eye movement (REM) sleep duration have been associated with long-term mortality in non-surgical cohorts, the impact of preoperative sleep on postoperative outcomes has not been well studied. METHODS: In this secondary analysis of a prospective observational cohort study, patients who recorded at least 1 sleep episode using a consumer wearable device in the 7 days before elective colorectal surgery were included. 30-day postoperative outcomes among those who did and did not receive at least 6 h of total sleep, as well as those who did and did not receive at least 1 h of rapid eye movement (REM) sleep, were compared. RESULTS: 34 out of 95 (35.8%) patients averaged at least 6 h of sleep per night, while 44 out of 82 (53.7%) averaged 1 h or more of REM sleep. Patients who slept less than 6 h had similar postoperative outcomes compared to those who slept 6 h or more. Patients who averaged less than 1 h of REM sleep, compared to those who achieved 1 h or more of REM sleep, had significantly higher rates of complication development (29.0% vs. 9.1%, P = 0.02), and return to the OR (10.5% vs. 0%, P = 0.04). After adjustment for confounding factors, increased REM sleep duration remained significantly associated with decreased complication development (increase in REM sleep from 50 to 60 min: OR 0.72, P = 0.009; REM sleep ≥ 1 h: OR 0.22, P = 0.03). CONCLUSION: In this cohort of patients undergoing elective colorectal surgery, those who developed a complication within 30 days were less likely to average at least 1 h of REM sleep in the week before surgery than those who did not develop a complication. Preoperative REM sleep duration may represent a risk factor for surgical complications; however additional research is necessary to confirm this relationship.
Authors: Traci L Hedrick; Taryn E Hassinger; Emma Myers; Elizabeth D Krebs; David Chu; Ashley N Charles; Sook C Hoang; Charles M Friel; Robert H Thiele Journal: Dis Colon Rectum Date: 2020-04 Impact factor: 4.585
Authors: Jane E Ferrie; Martin J Shipley; Francesco P Cappuccio; Eric Brunner; Michelle A Miller; Meena Kumari; Michael G Marmot Journal: Sleep Date: 2007-12 Impact factor: 5.849
Authors: Michael M H Yang; Rebecca L Hartley; Alexander A Leung; Paul E Ronksley; Nathalie Jetté; Steven Casha; Jay Riva-Cambrin Journal: BMJ Open Date: 2019-04-01 Impact factor: 2.692