Sleep hygiene linked to patient-reported outcomes & objective sleep measures prior to upper extremity orthopaedic surgery.

IF 2.5 Q2 CLINICAL NEUROLOGY
Frontiers in pain research (Lausanne, Switzerland) Pub Date : 2025-06-11 eCollection Date: 2025-01-01 DOI:10.3389/fpain.2025.1589748
Nicholas A Giordano, Tatiana Getz, Michael Gottschalk, Andrew H Miller, Kim Dupree Jones, Jasmine Park, Yining Zhu, Annabelle Gong, Jack Hudson, Selma Selimovic, Sarah M Taub, Amanda K Klosky, Eric R Wagner
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引用次数: 0

Abstract

Background: Sleep hygiene is a modifiable factor that influences sleep quality, which is vital to the body's healing process and pain response. However, poor sleep hygiene, characterized by irregular sleep schedules, inappropriate sleep environments, or the use of stimulants before bedtime, can exacerbate sleep disturbances and impairment, thus diminishing sleep quality, exacerbating pain hypersensitivity, and protracting postoperative recovery. Despite being modifiable, sleep hygiene is rarely assessed preoperatively and may be a driver of the relationship between poor sleep quality and pain response in surgical patient populations. Furthermore, there is a dearth of research examining the relationship between sleep hygiene and objective sleep measures in an ambulatory surgical patient population.

Purpose: This analysis examined the association between sleep hygiene habits and both pain and sleep quality in a sample of patients undergoing orthopaedic surgery utilizing patient-reported outcomes and objective longitudinal measures of sleep quality, known as actigraphy.

Methods: Participants undergoing orthopaedic surgery on their upper extremity at a large urban academic medical center in the Southeastern United States were recruited, consented, and enrolled in this study approximately 2 weeks before surgery between March 2022 and April 2023. Participants completed a series of surveys assessing their sleep hygiene, sleep quality, and pain interference preoperatively. For example, participants completed the Sleep Hygiene Index and the Patient-Reported Outcome Measurement Information System (PROMIS) Pain Interference measure. In addition, participants wore an actigraphy device on the wrist of their non-surgical extremity, which measured sleep efficiency and total sleep time in the days prior to surgery. Linear regressions examined the association between preoperative sleep hygiene scores and pain interference, sleep efficiency, and total sleep time.

Results: This sample included 30 participants. The average Sleep Hygiene Index score was 10.87 (±6.71) and the sample's average PROMIS Pain Interference T-score was 63.73 (±9.59). Actigraphy derived total sleep time per day was 362.97 (±154.02) minutes and an average sleep efficiency score of 91.98 (±3.72). Regression models showed that poorer sleep hygiene (e.g., higher scores) was associated with worse PROMIS Pain Interference T-scores (95% CI: 0.14, 1.04; p = .04). In addition, participants with worse sleep hygiene scores had worse sleep efficiency (β = -0.21; 95% CI: -0.41, -0.014; p = .037) and had fewer minutes in their total sleep time (β = -8.91; 95% CI: -17.10, -0.72; p = .034).

Conclusion: This analysis indicates that poorer sleep hygiene is associated with both increased pain interference and poorer sleep quality among patients about to undergo orthopaedic surgery on their upper extremity. These findings highlight the need to assess and educate patients on proper sleep hygiene prior to surgery in an effort to help foster high-quality restorative sleep that promotes postoperative recovery. This study is among the first to examine the possible contributions of sleep hygiene, a modifiable factor, on both patient-reported outcomes and objective measures of sleep over a prolonged period among patients undergoing orthopaedic surgery in an ambulatory setting.

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睡眠卫生与上肢矫形手术前患者报告的结果和客观睡眠测量相关。
背景:睡眠卫生是影响睡眠质量的可变因素,对身体的愈合过程和疼痛反应至关重要。然而,不良的睡眠卫生,以不规律的睡眠时间表、不适当的睡眠环境或睡前使用兴奋剂为特征,可加剧睡眠障碍和损害,从而降低睡眠质量,加剧疼痛过敏,延长术后恢复时间。尽管睡眠卫生可以改变,但术前很少评估睡眠卫生,这可能是手术患者睡眠质量差和疼痛反应之间关系的驱动因素。此外,在门诊手术患者群体中,关于睡眠卫生和客观睡眠测量之间关系的研究也很缺乏。目的:本分析利用患者报告的结果和客观的睡眠质量纵向测量,即活动记录仪,研究了接受骨科手术的患者样本中睡眠卫生习惯与疼痛和睡眠质量之间的关系。方法:在2022年3月至2023年4月期间,在美国东南部的一个大型城市学术医疗中心招募、同意并在手术前约2周入组接受上肢矫形手术的参与者。参与者完成了一系列的调查,评估他们的睡眠卫生、睡眠质量和术前疼痛干扰。例如,参与者完成了睡眠卫生指数和患者报告的结果测量信息系统(PROMIS)疼痛干扰测量。此外,参与者在手腕上佩戴了一个活动记录仪,用于测量手术前几天的睡眠效率和总睡眠时间。线性回归检验了术前睡眠卫生评分与疼痛干扰、睡眠效率和总睡眠时间之间的关系。结果:本样本包括30名参与者。睡眠卫生指数平均得分为10.87(±6.71)分,PROMIS疼痛干扰t -评分平均得分为63.73(±9.59)分。活动描记得出的每天总睡眠时间为362.97(±154.02)分钟,平均睡眠效率评分为91.98(±3.72)分。回归模型显示,较差的睡眠卫生(例如较高的评分)与较差的PROMIS疼痛干扰t -评分相关(95% CI: 0.14, 1.04;p = .04)。此外,睡眠卫生得分较差的参与者睡眠效率也较差(β = -0.21;95% ci: -0.41, -0.014;P = 0.037),总睡眠时间较短(β = -8.91;95% ci: -17.10, -0.72;p = .034)。结论:本分析表明,在即将接受上肢矫形手术的患者中,较差的睡眠卫生与疼痛干扰增加和较差的睡眠质量有关。这些发现强调了在手术前评估和教育患者正确的睡眠卫生的必要性,以帮助培养高质量的恢复性睡眠,促进术后恢复。这项研究是第一个研究睡眠卫生(一个可改变的因素)对患者报告的结果和在门诊环境中接受骨科手术的患者长期睡眠的客观测量的可能贡献的研究之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
2.10
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0.00%
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