Incidence and risk factors of postoperative sleep disorders in patients with malignancy after radical surgery

Abstract

Purpose This prospective cohort study was designed to evaluate the incidence of and identify the risk factors associated with sleep disorders in patients with cancer following radical surgery. Methods In total, 297 patients with cancer underwent elective radical surgery in the Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, between October 2020 and December 2021. Patients were divided into two groups according to a Pittsburgh Sleep Quality Index (PSQI) score ≥ 8: a sleep-disorder group and no-sleep-disorder group. Data pertaining to preoperative, intraoperative, and postoperative risk factors were recorded. Logistic regression analysis was conducted to explore the risk factors associated with sleep disorders in this patient population. Results The prevalence of postoperative sleep disorders in patients with cancer after radical surgery was 63.64%. The preoperative PSQI score, postoperative sleep apnoea syndrome (SAS) score, tumour type, moderate and severe postoperative pain, remaining in confined spaces, and education level were significantly associated with postoperative sleep disorders. The area under the curve was 0.87. Conclusions We should pay attention to patients with cancer who have undergone radical surgery and have higher preoperative PSQI scores, postoperative SAS scores, moderate and severe postoperative pain, higher education level, and remain in confined spaces. A multimodal approach including preoperative education, postoperative multimodal analgesia, improvement of the environment, and use of some medication types could improve transient sleep disturbances in patients with cancer after radical surgery.