Preoperative slow‐wave sleep is associated with postoperative delirium after heart valve surgery: A prospective pilot study

Abstract

SummaryPostoperative delirium (POD) is a very common neurological complication after valve surgery. Some studies have shown that preoperative sleep disorder is associated with POD, but the correlation between preoperative slow wave sleep (SWS) and POD remains unclear. Therefore, this study aims to identify the correlation between preoperative slow wave sleep and postoperative delirium in patients with heart valve disease. This was a prospective, observational study of elective valve surgery patients admitted to the Heart Medical Center between November 2021 and July 2022. Polysomnography (PSG) was used to monitor sleep architecture from 9:30 p.m. for 1 night before surgery to 6:30 a.m. on the day of surgery. Patients were assessed for postoperative delirium from postoperative day 1 to extubation or day 5 by using the Richmond Agitation/Sedation Scale (RASS) and the Confusion Assessment Method for the Intensive Care Unit (CAM‐ICU). A total of 60 elective valve surgery patients were enrolled in this study. Prolonged N1 (11.44%) and N2 (58.62%) sleep, decreased N3 sleep (8.75%) and REM sleep (18.24%) within normal limits were the overall sleep architecture. Compared with patients without POD, patients with POD had less slow wave sleep 1 night before surgery (5.77% vs 10.88%, p < 0.001). After adjusting for confounding factors, slow wave sleep (OR: 0.647, 95% CI 0.493–0.851, p = 0.002) was found to be a protective factor for postoperative delirium. The preoperative SWS is a predictive factor of the POD in patients undergoing valve surgery. But further studies with larger sample sizes are still needed to elucidate the relationship between preoperative slow wave sleep and postoperative delirium.

Effects of Intranasal Insulin Pretreatment on Preoperative Sleep Quality and Postoperative Delirium in Patients Undergoing Valve Replacement for Rheumatic Heart Disease

“…Preoperative negative emotions such as fear and anxiety, in patients undergoing valve replacement surgery due to uncertainties regarding the operation procedure can seriously affect patient sleep quality. 2 Sleep is crucial for maintaining optimal brain function. 3 Research 4 has shown that insufficient sleep can lead to an increase in the release of inflammatory cytokines, thereby activating microglia.…”

Poor sleep and insomnia, sleep disordered breathing, methodology, sleep and neurology, and much more!

“…Lin et al (2023) investigated whether the amount of preoperative slow-wave sleep (SWS) is associated with postoperative delirium after heart valve surgery. In this pilot study, 60 patients undergoing elective valve surgery were enrolled.…”