The prevalence and risk factors of sleep disturbances in surgical patients: A systematic review and meta-analysis

Butris, Nina; Tang, Evan; Pivetta, Bianca; He, David; Saripella, Aparna; Yan, Ellene; Englesakis, Marina; Boulos, Mark I.; Nagappa, Mahesh; Chung, Frances

doi:10.1016/j.smrv.2023.101786

Cited by 13 publications

(7 citation statements)

References 71 publications

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“…Moreover, sleep disorders are the major symptoms of depression, manifested by decreased sleep efficiency and increased REM sleep time ( 31 ). The relationship is likely to be bidirectional as sleep disorders worsen negative emotions, while negative emotions similarly exacerbate sleep disorders ( 18 ). Hospital environmental factors can also compromise sleep quality.…”

Section: Discussionmentioning

confidence: 99%

“…Reduced total sleep time, prolonged sleep onset latency, obstructive sleep apnea syndrome, sleep fragmentation, and disrupted sleep architecture are the main perioperative sleep disorders observed in previous studies ( 15 – 17 ). Multiple factors may contribute to or aggravate abnormal sleep during the perioperative period, including factors such as psychological status, ward environment, nursing interventions, surgery, and anesthetic drugs ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

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Associations between perioperative sleep patterns and clinical outcomes in patients with intracranial tumors: a correlation study

Liu,

Wu,

Zhang

et al. 2023

Front. Neurol.

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ObjectiveAlthough the quality of perioperative sleep is gaining increasing attention in clinical recovery, its impact role remains unknown and may deserve further exploration. This study aimed to investigate the associations between perioperative sleep patterns and clinical outcomes among patients with intracranial tumors.MethodsA correlation study was conducted in patients with intracranial tumors. Perioperative sleep patterns were assessed using a dedicated sleep monitor for 6 consecutive days. Clinical outcomes were gained through medical records and follow-up. Spearman's correlation coefficient and multiple linear regression analysis were applied to evaluate the associations between perioperative sleep patterns and clinical outcomes.ResultsOf 110 patients, 48 (43.6%) were men, with a median age of 57 years. A total of 618 days of data on perioperative sleep patterns were collected and analyzed. Multiple linear regression models revealed that the preoperative blood glucose was positively related to the preoperative frequency of awakenings (β = 0.125; 95% CI = 0.029–0.221; P = 0.011). The level of post-operative nausea and vomiting was negatively related to perioperative deep sleep time (β = −0.015; 95% CI = −0.027–−0.003; P = 0.015). The level of anxiety and depression was negatively related to perioperative deep sleep time, respectively (β = −0.048; 95% CI = −0.089–0.008; P = 0.020, β = −0.041; 95% CI = −0.076–0.006; P = 0.021). The comprehensive complication index was positively related to the perioperative frequency of awakenings (β = 3.075; 95% CI = 1.080–5.070; P = 0.003). The post-operative length of stay was negatively related to perioperative deep sleep time (β = −0.067; 95% CI = −0.113–0.021; P = 0.005). The Pittsburgh Sleep Quality Index was positively related to perioperative sleep onset latency (β = 0.097; 95% CI = 0.044–0.150; P < 0.001) and negatively related to perioperative deep sleep time (β = −0.079; 95% CI = −0.122–0.035; P < 0.001).ConclusionPerioperative sleep patterns are associated with different clinical outcomes. Poor perioperative sleep quality, especially reduced deep sleep time, has a negative impact on clinical outcomes. Clinicians should, therefore, pay more attention to sleep quality and improve it during the perioperative period.Clinical trial registrationhttp://www.chictr.org.cn, identifier: ChiCTR2200059425.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations between perioperative sleep patterns and clinical outcomes in patients with intracranial tumors: a correlation study

Liu,

Wu,

Zhang

et al. 2023

Front. Neurol.

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“…(4) Postoperative pain level during rest and physical activity measured with a 0-10 point VAS Postoperative pain level during rest and physical activity will be evaluated daily using the VAS [36]. Furthermore, the dosages of all opioids for postoperative pain control will be recorded and converted to morphine milligram equivalents.…”

Section: Secondary Outcomesmentioning

confidence: 99%

Short-term inhalation of xenon during anesthesia for prevention of postoperative delirium in elderly patients undergoing laparoscopic radical colectomy: study protocol for a randomized controlled clinical trial

Cheng,

Gao,

Liu

et al. 2024

Preprint

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Background: Postoperative delirium (POD) is a common complication that is characterized by acute onset of impaired cognitive function and is associated with an increased mortality, a prolonged duration of hospital stay and additional healthcare expenditures. The incidence of POD in elderly patients undergoing laparoscopic radical colectomy ranges from 8% to 54%. Xenon has been shown a neuroprotection in various neural injury models, but the clinic researches assessing the preventive effect of xenon inhalation on the occurrence of POD obtain the controversial findings. This study aims to investigate the effects of a short xenon inhalation on the occurrence of POD in elderly patients undergoing laparoscopic radical colectomy. Methods/Design: This is a prospective, randomized, controlled trial and 132 patients aged 65-80 years and scheduled for laparoscopic radical colectomy will be enrolled. The participants will be randomly assigned to either the control group or the xenon group (n=66 in each group). The primary outcome will be the incidence of POD in the first 5 days after surgery. Secondary outcomes will include the subtype, severity and duration of POD, postoperative pain score, Pittsburgh Sleep Quality Index (PQSI), perioperative non-delirium complications, and economic parameters. Additionally, the study will investigate the activation of microglial cells, expression of inflammatory factors in colon tissues, plasma inflammatory factors and neurochemical markers. Discussion: Elderly patients undergoing laparoscopic radical colectomy are at a high risk of POD, with delayed postoperative recovery and increased healthcare costs. The primary objective of this study is to determine the preventive effect of a short xenon inhalation on the occurrence of POD in these patients. Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR2300076666, registered on October 16, 2023, http://www. chictr.org.cn.

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“… 2 In the perioperative context, SD can be as high as 60%, influenced by factors such as underlying health conditions, environment, and psychological factors. 3 It is noteworthy that the incidence of postoperative SD is also significant concern. A multicenter cross‐sectional survey identified a postoperative SD incidence of 64.9%.…”

Section: Sdmentioning

confidence: 99%

“…Concurrently, sleep disorders (SD) become a growing threat to the health of the elderly with aging. 2 , 3 , 4 , 5 SD is not only linked to a range of medical conditions such as diabetes, hypertension, cardiovascular diseases, cancer, metabolic syndrome, and hyperlipidemia, but also associated with endocrine imbalance, immune suppression, increased pain sensitivity, cognitive impairment, and psychiatric abnormalities, all of which negatively impact postoperative outcomes and long‐term survival in elderly patients. 3 , 4 , 6 More importantly, SD may occur after surgery, which can directly exert promoting effects on PND given the critical function of sleep in memory consolidation and the negative impact of sleep disturbances on cognitive function.…”

Section: Introductionmentioning

confidence: 99%

The influence of sleep disorders on perioperative neurocognitive disorders among the elderly: A narrative review

Chen,

Zhai,

Lan

et al. 2024

Ibrain

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This review comprehensively assesses the epidemiology, interaction, and impact on patient outcomes of perioperative sleep disorders (SD) and perioperative neurocognitive disorders (PND) in the elderly. The incidence of SD and PND during the perioperative period in older adults is alarmingly high, with SD significantly contributing to the occurrence of postoperative delirium. However, the clinical evidence linking SD to PND remains insufficient, despite substantial preclinical data. Therefore, this study focuses on the underlying mechanisms between SD and PND, underscoring that potential mechanisms driving SD‐induced PND include uncontrolled central nervous inflammation, blood–brain barrier disruption, circadian rhythm disturbances, glial cell dysfunction, neuronal and synaptic abnormalities, impaired central metabolic waste clearance, gut microbiome dysbiosis, hippocampal oxidative stress, and altered brain network connectivity. Additionally, the review also evaluates the effectiveness of various sleep interventions, both pharmacological and nonpharmacological, in mitigating PND. Strategies such as earplugs, eye masks, restoring circadian rhythms, physical exercise, noninvasive brain stimulation, dexmedetomidine, and melatonin receptor agonists have shown efficacy in reducing PND incidence. The impact of other sleep‐improvement drugs (e.g., orexin receptor antagonists) and methods (e.g., cognitive‐behavioral therapy for insomnia) on PND is still unclear. However, certain drugs used for treating SD (e.g., antidepressants and first‐generation antihistamines) may potentially aggravate PND. By providing valuable insights and references, this review aimed to enhance the understanding and management of PND in older adults based on SD.

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The prevalence and risk factors of sleep disturbances in surgical patients: A systematic review and meta-analysis

Cited by 13 publications

References 71 publications

Associations between perioperative sleep patterns and clinical outcomes in patients with intracranial tumors: a correlation study

Associations between perioperative sleep patterns and clinical outcomes in patients with intracranial tumors: a correlation study

Short-term inhalation of xenon during anesthesia for prevention of postoperative delirium in elderly patients undergoing laparoscopic radical colectomy: study protocol for a randomized controlled clinical trial

The influence of sleep disorders on perioperative neurocognitive disorders among the elderly: A narrative review

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