Le lien potentiel entre l’apnée obstructive du sommeil et les troubles neurocognitifs postopératoires : connaissances actuelles et mécanismes possibles

Devinney, Michael J.; VanDusen, Keith W.; Kfouri, Jad M.; Avasarala, Pallavi; Spector, Andrew R.; Mathew, Joseph P.; Berger, Miles

doi:10.1007/s12630-022-02302-4

Cited by 2 publications

(3 citation statements)

References 108 publications

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“…While we do control for orthopaedic surgery type, duration and type of anaesthesia, other unmeasured hospitalisation-related factors may not be accounted for. Additionally, while we assess for sleep apnoea risk, we do not perform gold-standard diagnosis (eg, home sleep apnoea testing45), which has potential links to POD 46…”

Section: Methods and Analysismentioning

confidence: 99%

“…Additionally, while we assess for sleep apnoea risk, we do not perform gold-standard diagnosis (eg, home sleep apnoea testing 45 ), which has potential links to POD. 46 Patient burden during the study could originate from discomfort while wearing the actiwatch and fatigue during cognitive assessments. When possible, blood collection will be performed while the patient is under general anaesthesia and extracted from an indwelling line to minimise patient discomfort.…”

Section: Limitationsmentioning

confidence: 99%

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Sleep and circadian biomarkers of postoperative delirium (SLEEP-POD): protocol for a prospective and observational cohort study

Sugg,

Gleeson,

Baker

et al. 2024

BMJ Open

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IntroductionSurgical patients over 70 experience postoperative delirium (POD) complications in up to 50% of procedures. Sleep/circadian disruption has emerged as a potential risk factor for POD in epidemiological studies. This protocol presents a single-site, prospective observational study designed to examine the relationship between sleep/circadian regulation and POD and how this association could be moderated or mediated by Alzheimer’s disease (AD) pathology and genetic risk for AD.Methods and analysisStudy staff members will screen for eligible patients (age ≥70) seeking joint replacement or spinal surgery at Massachusetts General Hospital (MGH). At the inclusion visit, patients will be asked a series of questionnaires related to sleep and cognition, conduct a four-lead ECG recording and be fitted for an actigraphy watch to wear for 7 days before surgery. Blood samples will be collected preoperatively and postoperatively and will be used to gather information about AD variant genes (APOE-ε4) and AD-related pathology (total and phosphorylated tau). Confusion Assessment Method-Scale and Montreal Cognitive Assessment will be completed twice daily for 3 days after surgery. Seven-day actigraphy assessments and Patient-Reported Outcomes Measurement Information System questionnaires will be performed 1, 3 and 12 months after surgery. Relevant patient clinical data will be monitored and recorded throughout the study.Ethics and disseminationThis study is approved by the IRB at MGH, Boston, and it is registered with the US National Institutes of Health on ClinicalTrials.gov (NCT06052397). Plans for dissemination include conference presentations at a variety of scientific institutions. Results from this study are intended to be published in peer-reviewed journals. Relevant updates will be made available on ClinicalTrials.gov.Trial registration numberNCT06052397.

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Section: Methods and Analysismentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Sleep and circadian biomarkers of postoperative delirium (SLEEP-POD): protocol for a prospective and observational cohort study

Sugg,

Gleeson,

Baker

et al. 2024

BMJ Open

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“…In patients with intracranial tumors, previous studies have found that more than 60% of patients have sleep disorders, with one in five reporting insomnia ( 9 ). Perioperative sleep disorders can retard wound healing ( 10 ), result in mood disorders and post-operative cognitive dysfunction ( 7 , 11 , 12 ), increase respiratory and cardiovascular complications ( 13 , 14 ), and prolong hospital stays ( 2 ). Different types and degrees of sleep disorders, mainly manifesting as abnormalities in sleep quantity and quality, were under-recognized in clinical studies.…”

Section: Introductionmentioning

confidence: 99%

Associations between perioperative sleep patterns and clinical outcomes in patients with intracranial tumors: a correlation study

Liu,

Wu,

Zhang

et al. 2023

Front. Neurol.

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ObjectiveAlthough the quality of perioperative sleep is gaining increasing attention in clinical recovery, its impact role remains unknown and may deserve further exploration. This study aimed to investigate the associations between perioperative sleep patterns and clinical outcomes among patients with intracranial tumors.MethodsA correlation study was conducted in patients with intracranial tumors. Perioperative sleep patterns were assessed using a dedicated sleep monitor for 6 consecutive days. Clinical outcomes were gained through medical records and follow-up. Spearman's correlation coefficient and multiple linear regression analysis were applied to evaluate the associations between perioperative sleep patterns and clinical outcomes.ResultsOf 110 patients, 48 (43.6%) were men, with a median age of 57 years. A total of 618 days of data on perioperative sleep patterns were collected and analyzed. Multiple linear regression models revealed that the preoperative blood glucose was positively related to the preoperative frequency of awakenings (β = 0.125; 95% CI = 0.029–0.221; P = 0.011). The level of post-operative nausea and vomiting was negatively related to perioperative deep sleep time (β = −0.015; 95% CI = −0.027–−0.003; P = 0.015). The level of anxiety and depression was negatively related to perioperative deep sleep time, respectively (β = −0.048; 95% CI = −0.089–0.008; P = 0.020, β = −0.041; 95% CI = −0.076–0.006; P = 0.021). The comprehensive complication index was positively related to the perioperative frequency of awakenings (β = 3.075; 95% CI = 1.080–5.070; P = 0.003). The post-operative length of stay was negatively related to perioperative deep sleep time (β = −0.067; 95% CI = −0.113–0.021; P = 0.005). The Pittsburgh Sleep Quality Index was positively related to perioperative sleep onset latency (β = 0.097; 95% CI = 0.044–0.150; P < 0.001) and negatively related to perioperative deep sleep time (β = −0.079; 95% CI = −0.122–0.035; P < 0.001).ConclusionPerioperative sleep patterns are associated with different clinical outcomes. Poor perioperative sleep quality, especially reduced deep sleep time, has a negative impact on clinical outcomes. Clinicians should, therefore, pay more attention to sleep quality and improve it during the perioperative period.Clinical trial registrationhttp://www.chictr.org.cn, identifier: ChiCTR2200059425.

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Le lien potentiel entre l’apnée obstructive du sommeil et les troubles neurocognitifs postopératoires : connaissances actuelles et mécanismes possibles

Cited by 2 publications

References 108 publications

Sleep and circadian biomarkers of postoperative delirium (SLEEP-POD): protocol for a prospective and observational cohort study

Sleep and circadian biomarkers of postoperative delirium (SLEEP-POD): protocol for a prospective and observational cohort study

Associations between perioperative sleep patterns and clinical outcomes in patients with intracranial tumors: a correlation study

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