Sleep Disruption at Home As an Independent Risk Factor for Postoperative Delirium

Abstract

Older people with sleep disruption at home are at significantly higher risk of developing postoperative delirium than those without. Sleep disruption in the hospital may further heighten this risk.

Improve postoperative sleep

“…Sleep disturbances are considered important risk factors of delirium development. In patients undergoing arthroplasty or noncardiac surgery, preoperative sleep disruption was associated with an increased risk of postoperative delirium [ 21 , 22 ▪ ]. In elderly patients undergoing arthroplasty, preexisting OSA was a significant predictor of postoperative delirium [ 23 ].…”

Perioperative Sleep Disturbances and Postoperative Delirium in Adult Patients: A Systematic Review and Meta-Analysis of Clinical Trials

“…In one retrospective trial, the control group was matched for age, sex, operated side, type of operation, mode of component fixation, year of operation, surgeon, and type of anesthesia ( 28 ). In seven trials, patients only underwent cardiac surgery ( 33 , 36 – 39 , 42 , 44 ), in 20 trials, only non-cardiac surgeries ( 17 , 18 , 27 – 30 , 32 , 34 , 35 , 40 , 41 , 43 , 45 – 52 ), and in two trials, both cardiac and non-cardiac surgeries ( 16 , 31 ). All the patients in the included RCTs underwent non-cardiac surgeries.…”

“…We obtained the mean age of patients in each study by adding the mean age of patients in each group and then dividing by two. In 19 trials, the mean age was 65 years or older ( 17 , 18 , 28 , 30 – 32 , 34 , 35 , 37 – 40 , 45 , 46 , 48 – 52 ), though one trial did not provide participants' ages ( 36 ). Males accounted for 50% or more of all patients in 16 trials ( 16 – 18 , 28 , 31 , 33 , 35 , 37 – 39 , 41 – 45 , 47 ), though two trials did not provide sex-related information ( 36 , 51 ).…”

The Incidence of Recorded Delirium Episodes Before and After Dementia Diagnosis: Differences Between Dementia With Lewy Bodies and Alzheimer's Disease

“…Particular areas that may be explored would be the circadian domain which is composed of motor behaviour and sleep-wake cycle disturbances, both of which are core features of delirium and DLB 17 . Use of bioelectronics measures such as actigraphy and psychometric measures have shown to have utility in exploring delirium circadian phenomenology and progress our understanding of the interface between delirium and dementia 37,38 . This would enable researchers to identify specific areas to implement routine delirium screening to aid frontline staff in parsing out suspected delirium from DLB and hence initiate appropriate management for each patient.…”