Sleep disturbances after cardiac surgery with or without elevated S100B levels

Işkesen, İhsan; Kurdal, Adnan Taner; Yılmaz, Hikmet; Cerrahoğlu, Mustafa; Şirin, Bekir Hayrettin

doi:10.2143/ac.64.6.2044737

Cited by 13 publications

(15 citation statements)

References 21 publications

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“…The sleep time tended to normalize after one month but could be affected as long as 6 months postoperatively. Sleep efficiency was measured in 7 of the 9 studies [25][26][27]31,32,35,36 and showed the same tendency as total sleep time, with a reduction in the first postoperative week and normalization one month postoperatively. An age effect was shown, where people < 60 years returned to preoperative values after one month, but people > 60 years needed 2 months to return to preoperative values.…”

Section: Cardiac Surgerymentioning

confidence: 87%

“…Of the 24 studies in which actigraphy was used to assess sleep, 9 studies were in patients undergoing cardiac surgery, [25][26][27],31-36 6 general surgery, 2,[22][23][24]37,38 5 outpatient surgery, 39-43 2 breast surgery, 44,45 and the last 2 studies involved gynecological/obstetric surgery. 46,47 Three studies were randomized clinical trials.…”

Section: Sleepmentioning

confidence: 99%

“…The smallest study included 11 patients, and the largest included 169 patients. In 12 studies there was a control group 22,[24][25][26][27]32,[40][41][42][43]46,47 ; 5 of these studies included healthy controls. 22,26,27,40,41 In 23 of the 24 studies, total sleep time/nighttime sleep was assessed by actigraphy ( Table 1).…”

Section: Sleepmentioning

confidence: 99%

“…In the 9 studies including patients undergoing cardiac surgery, [25][26][27][31][32][33][34][35][36] the population size was 13-129. Most of the procedures were coronary artery bypass surgery [25][26][27][32][33][34][35][36] ; one was placement of a left ventricular assist device through an open procedure.…”

Section: Cardiac Surgerymentioning

confidence: 99%

“…Most of the procedures were coronary artery bypass surgery [25][26][27][32][33][34][35][36] ; one was placement of a left ventricular assist device through an open procedure. 31 Six of the 9 studies included both preoperative and postoperative values, [25][26][27]31,34,35 with only postoperative values in the remaining 3 studies. 32,33,36 When using actigraphy to assess sleep after cardiac surgery, it was shown that total sleep time was reduced in the first week after surgery.…”

Section: Cardiac Surgerymentioning

confidence: 99%

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Actigraphy for Measurement of Sleep and Sleep-Wake Rhythms in Relation to Surgery

Madsen

Rosenberg²,

Gögenur³

2013

Journal of Clinical Sleep Medicine

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Study Objectives: Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify these disturbances. The aim of this manuscript was to present the literature where actigraphy has been used to measure sleep and sleep-wake rhythms in relation to surgery. methods: A systematic review was performed in 3 databases (Medline, Embase, and Psycinfo), including all literature until July 2012. Results: Thirty-two studies were included in the review. Actigraphy could demonstrate that total sleep time and sleep effi ciency was reduced after surgery and number of awakenings was increased in patients undergoing major surgery. Disturbances were less severe in patients undergoing minor surgery.Actigraphy could be used to differentiate between delirious and non-delirious patients after major surgery. Actigraphy measurements could determine a differential effect of surgery based on the patient's age. The effect of pharmacological interventions (chronobiotics and hypnotics) in surgical patients could also be demonstrated by actigraphy. Conclusion: Actigraphy can be used to measure sleep and sleep-wake rhythms in patients undergoing surgery. keywords: Actigraphy, surgery, sleep disturbances, sleepwake rhythm, and activity Citation: Madsen MT; Rosenberg J; Gögenur I. Actigraphy for measurement of sleep and sleep-wake rhythms in relation to surgery. J Clin Sleep Med 2013;9(4):387-394.http://dx.doi.org/10.5664/jcsm.2598 R e v I e W A R T I C l e D isturbed sleep and sleep-wake rhythms represent a major problem for patients after surgery 1 and may result in prolonged postoperative convalescence, 2 cardiovascular morbidity, 3-5 cognitive dysfunction, 6,7 and impaired immune function. [8][9][10][11] Furthermore, improved morbidity and mortality has been correlated with a more marked rest-activity rhythm. 12,13The golden standard for measuring sleep is polysomnography (PSG). Although ambulatory devices have been developed the method includes multiple electrodes, resulting in reduced mobility and discomfort.14 The analysis of a PSG recording is also resource demanding, 15 and there exists no automatic analysis scoring system with suffi cient reliability.16 An actigraph, which is a small wrist-worn device, can be used to measure sleep, circadian rhythm, activity rhythm, and activity in general. 17 The advantages of actigraphy are high level of mobility, 14 the possibility of measuring over longer periods of time (days to months), 18 low cost, 18 and minimal data editing required for data analysis. 15,19 Actigraphy has been validated against polysomnography with high levels of sensitivity and specifi city in various nonsurgical patient populations. 17,18,20,21 In this systematic review, we present an overview of studies where actigraphy has been used to describe sleep and sleep-wake rhythms in relation to surgery, including patients undergoing cardiac surgery, general surgery, and ambulatory surgery. The strengths and weaknesses of actigraphy...

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