Prospective Assessment of Sleep Quality Before and After Primary Total Joint Replacement

Abstract

Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration. In the early postoperative period (4.7±2.0 weeks), patients reported significant increases in sleep disturbance as denoted by increased length of time to fall asleep (P=.006) and mean nightly awakenings (P=.002) compared with the preoperative baseline. At late postoperative follow-up (40.8±19.5 weeks), patients' sleep quality subsequently improved above the preoperative baseline. Approximately 40% of patients tried a new sleeping method postoperatively, the most common being new pillow placement. No significant differences in pre- or postoperative sleeping trends were noted between THA and TKA patients. These findings suggest transient sleep disturbance is common in the early postoperative period, with subsequent improvement by 10-month follow-up after a primary TJA. Given the growing importance of patient satisfaction in health care systems, orthopedic surgeons must manage patients' expectations while working with them to optimize sleep quality after TJA. A multimodal approach with preoperative counseling, early postoperative sleep modifications, and possibly preemptive use of medications may improve transient sleep disturbance among TJA patients. [Orthopedics. 2017; 40(4):e636-e640.].

A Randomized Controlled Study on the Safety and Effectiveness of Total Knee Arthroplasty Operated At Different Times under ERASA.

“…Studies have shown that there is a statistically signi cant correlation between pain intensity and sleep quality. Besides, nighttime pain is signi cantly associated with joint swelling, elevated ESR, and CRP, all of which are consistent with the characteristics of local and systemic reactions in TKA surgery (24)(25)(26). Our result shows there is no signi cant difference between the groups on the above indicators and found improved after surgery.…”

“…As can be seen from the results of this study, the pain during the follow-up period has been greatly reduced compared with before the operation. Patients may suffer from sleep disorders due to pain, socioeconomic burden, and even mental disorders before receiving TKA, and sleep disorders are also prone to occur after TKA (24). Research conducted by Brien suggests that lack of sleep (4 hours or less) may result in decreased daily performance and persistent inattention.…”

Sleep improvement after hip arthroplasty: a study on short-stem prosthesis

“…Sleep disorder in patients with osteoarthrosis in the hip or other joints is a common condition [18]. Pain is an essential parameter in patients with sleep disturbance and osteoarthrosis [8,18,19]. Multiple studies have demonstrated that primary hip arthroplasty improves patients' quality of life as well as sleep disturbance after surgery.…”

“…Multiple studies have demonstrated that primary hip arthroplasty improves patients' quality of life as well as sleep disturbance after surgery. Most of the previous studies focused on the hospitalization period and the first weeks after surgery (up to 3 months) [8,18,20].…”

Insomnia is Associated with Depression and Anxiety in Patients Undergoing Noncardiac Surgery

“…Insomnia is one of the most common sleep disorders and a known risk factor for the incidence and severity of depression, recurrence of depressive episodes and even suicide [3]. Insomnia is common in patients during the perioperative period and produces negative consequences on postoperative recovery [4], such as pain, fatigue, then reducing the quality of life [5], especially in those with tumor surgery [6].…”