An in-depth analysis of postoperative insomnia in elderly patients and its implications on rehabilitation.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2024-10-01 Epub Date: 2024-06-11 DOI:10.1007/s11325-024-03063-8

Yuanqing Wang, Tianlong Wang, Shuai Feng, Ning Li, Yimeng Zhang, Yueyang Cheng, Hao Wu, Shuqin Zhan

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引用次数: 0

Abstract

Objectives: (1) Assess the prevalence of postoperative insomnia; (2) identify the risk factors for postoperative insomnia before exposure to surgery; (3) explore the impact of postoperative insomnia on rehabilitation.

Methods: A study was conducted with 132 participants aged ≥ 65 undergoing spine interbody fusion. We collected the basic demographic data, Numeric Rating Scales (NRS), Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS), and Beck Anxiety Inventory (BAI). We measured Quality of Recovery 40 (QoR-40), GDS, BAI, NRS, and PSQI on the first and third nights post-surgery, followed by QoR-40 and NRS assessments two weeks after surgery.

Results: The cases of postoperative insomnia on the first and third nights and after two weeks were 81 (61.36%), 72 (54.55%), and 64 (48.48%), respectively, and the type of insomnia was not significantly different (P = 0.138). Sleep efficiency on the first night was 49.96% ± 23.51. On the first night of postoperative insomnia, 54 (66.67%) cases were depression or anxiety, and the PSQI was higher in this group than in the group without anxiety or depression (P < 0.001). PSQI, GDS, and the time of surgery were related factors for postoperative insomnia (PPSQI < 0.001, PGDS = 0.008, and PTime = 0.040). Postoperative rehabilitation showed differences between the insomnia and non-insomnia groups (P < 0.001).

Conclusions: The prevalence of postoperative insomnia in the elderly was high, and postoperative insomnia had a significant correlation with postoperative rehabilitation. Interventions that target risk factors may reduce the prevalence of postoperative insomnia and warrant further research.

Clinical trial registration: Multivariate analysis of postoperative insomnia in elderly patients with spinal surgery and its correlation with postoperative rehabilitation ( https://www.chictr.org.cn/bin/project/edit?pid=170201 ; #ChiCTR2200059827).

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深入分析老年患者术后失眠及其对康复的影响。

目的：（1）评估术后失眠的发生率；（2）确定手术前术后失眠的风险因素；（3）探讨术后失眠对康复的影响：研究对象为132名年龄≥65岁的脊柱椎间融合术患者。我们收集了基本人口统计学数据、数字评分量表（NRS）、匹兹堡睡眠质量指数（PSQI）、老年抑郁量表（GDS）和贝克焦虑量表（BAI）。我们在术后第一夜和第三夜测量了恢复质量40（QoR-40）、GDS、BAI、NRS和PSQI，并在术后两周对QoR-40和NRS进行了评估：术后第一晚、第三晚和两周后失眠的病例分别为 81 例（61.36%）、72 例（54.55%）和 64 例（48.48%），失眠类型无显著差异（P = 0.138）。第一晚的睡眠效率为 49.96% ± 23.51。在术后失眠的第一晚，有 54 例（66.67%）为抑郁或焦虑，该组的 PSQI 值高于无焦虑或抑郁组（P 结论：抑郁或焦虑组的 PSQI 值高于无焦虑或抑郁组：老年人术后失眠的发生率很高，术后失眠与术后康复有显著相关性。针对风险因素的干预措施可降低术后失眠的发生率，值得进一步研究：脊柱手术老年患者术后失眠的多变量分析及其与术后康复的相关性 ( https://www.chictr.org.cn/bin/project/edit?pid=170201 ; #ChiCTR2200059827)。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.