Sleeping pattern before thoracic surgery: A comparison of baseline and night before surgery

Abstract

BackgroundSleep deprivation is considered a stress factor in the perioperative period. There are several studies on sleep disturbance after surgery but very limited literature available on preoperative sleep patterns, predictors of sleep disturbance and its effect on surgical outcome.MethodologyPatients scheduled for thoracic surgery were asked to fill out a written Pittsburgh Sleep Quality Index (PSQI) questionnaire. The primary investigator explained this form to all the patients. This was filled out before premedication for subjective assessment of sleeping pattern at two different time point. Only those patients included who spent the previous night at home. Participants were asked to respond to the questions regarding their baseline sleeping pattern and compare it with last night.ResultsTotal eighty-three patients with a mean age of 47.83 ± 17.88 were included in the study. Overall mean PSQI scores were significantly higher (p-value < 0.01) during the night before surgery (6.94 ± 2.115) when compared with baseline (3.88 ± 1.877). Sleep latency was also significantly affected when last night-1 (the night before admission) was compared with usual sleep latency. Twenty patients were unable to sleep more than 5 hrs at night before admission which was significant when compared with their last month status (20 vs 3). Logistic regression model demonstrated the age and Timing of surgery as a strong predictors of poor sleep (defined as PSQI ≥ 5).ConclusionQuality of sleep was profoundly affected at night before thoracic surgery, mainly due to a significant change in sleep latency and sleep duration. Although age and Timing of surgery were strong predictors of poor sleep we were unable to find any association between quality of sleep and type of surgery.

Familiarization with ambulatory sleep and blood pressure monitoring is necessary for representative data collection

“…Increased levels of cortisol, from the perceived stress of wearing the equipment for the first time, may contribute to elevated blood pressure on night 1 (Holt-Lunstad & Steffen, 2007). Anticipation of the unknown has also been shown to increase the stress response leading to a worsened sleep quality, as Mohammad et al (2019) have recently demonstrated. Our subjects showed the greatest amount of both cortical and autonomic arousals on night 1.…”

“…Anticipation of the unknown has also been shown to increase the stress response leading to a worsened sleep quality, as Mohammad et al. ( 2019 ) have recently demonstrated. Our subjects showed the greatest amount of both cortical and autonomic arousals on night 1.…”

Sleep Pattern Changes in Patients Who Are Scheduled for Cardiac Surgery

“…Age, gender, and the foods we eat, as well as our physical and mental health, all have an impact on how well we sleep. Sleep disruption has an impact on daily activities, health, and overall quality of life [ 4 , 8 - 9 ].…”

“…Sleep quality is inversely correlated with higher PSQI scores. A PSQI of 5 or more is regarded as having poor sleep quality [ 9 - 10 ]. We compared last month's sleep activity as a baseline before and after the surgery date was decided.…”

“…Given that this was a subjective assessment and that patients had trouble recalling the overall amount of time they had been interrupted. It's probably preferable to keep a sleep record for the entire month before answering this questionnaire [ 9 ]. Considerably, more than one sleep disruption will be considered a positive reaction, so it is probably inappropriate to compare last night's activity with that of the whole month.…”