A polysomnography study examining the association between sleep and postoperative delirium in older hospitalized cardiac surgical patients.
cardiac surgery
delirium
hospitalization
older
polysomnography
sleep
Journal
Journal of sleep research
ISSN: 1365-2869
Titre abrégé: J Sleep Res
Pays: England
ID NLM: 9214441
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
13
12
2020
received:
06
11
2020
accepted:
09
02
2021
pubmed:
25
3
2021
medline:
4
12
2021
entrez:
24
3
2021
Statut:
ppublish
Résumé
Hospitalized older patients who undergo elective cardiac surgery with cardiopulmonary bypass are prone to postoperative delirium. Self-reported shorter sleep and longer sleep have been associated with impaired cognition. Few data exist to guide us on whether shorter or longer sleep is associated with postoperative delirium in this hospitalized cohort. This was a prospective, single-site, observational study of hospitalized patients (>60 years) scheduled to undergo elective major cardiac surgery with cardiopulmonary bypass (n = 16). We collected and analysed overnight polysomnography data using the Somté PSG device and assessed for delirium twice a day until postoperative day 3 using the long version of the confusion assessment method and a structured chart review. We also assessed subjective sleep quality using the Pittsburg Sleep Quality Index. The delirium median preoperative hospital stay of 9 [Q1, Q3: 7, 11] days was similar to the non-delirium preoperative hospital stay of 7 [4, 9] days (p = .154). The incidence of delirium was 45.5% (10/22) in the entire study cohort and 50% (8/16) in the final cohort with clean polysomnography data. The preoperative delirium median total sleep time of 323.8 [Q1, Q3: 280.3, 382.1] min was longer than the non-delirium median total sleep time of 254.3 [210.9, 278.1] min (p = .046). This was accounted for by a longer delirium median non-rapid eye movement (REM) stage 2 sleep duration of 282.3 [229.8, 328.8] min compared to the non-delirium median non-REM stage 2 sleep duration of 202.5 [174.4, 208.9] min (p = .012). Markov chain modelling confirmed these findings. There were no differences in measures of sleep quality assessed by the Pittsburg Sleep Quality Index. Polysomnography measures of sleep obtained the night preceding surgery in hospitalized older patients scheduled for elective major cardiac surgery with cardiopulmonary bypass are suggestive of an association between longer sleep duration and postoperative delirium.
Identifiants
pubmed: 33759264
doi: 10.1111/jsr.13322
pmc: PMC8637551
mid: NIHMS1757772
doi:
Banques de données
ClinicalTrials.gov
['NCT03498560']
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13322Subventions
Organisme : NIA NIH HHS
ID : R01 AG053582
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG067985
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM007592
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 European Sleep Research Society.
Références
Eur J Neurosci. 2006 Apr;23(7):1738-46
pubmed: 16623830
Alzheimers Dement. 2020 May;16(5):726-733
pubmed: 32291901
Curr Epidemiol Rep. 2018 Jun;5(2):61-69
pubmed: 29984131
Science. 2020 Oct 2;370(6512):50-56
pubmed: 33004510
Brain. 2005 May;128(Pt 5):1049-61
pubmed: 15705609
Neurosci Lett. 2006 Jul 31;403(1-2):52-6
pubmed: 16714084
Neuropsychopharmacology. 2017 Jan;42(1):129-155
pubmed: 27510422
Asia Pac Psychiatry. 2015 Dec;7(4):375-82
pubmed: 26097170
Lancet. 2020 Jul 18;396(10245):177-185
pubmed: 32682483
Front Aging Neurosci. 2014 Jun 10;6:107
pubmed: 24959140
Sleep. 1986;9(3):405-14
pubmed: 3764288
Clin Neurophysiol. 2017 Aug;128(8):1421-1425
pubmed: 28618293
Rev Assoc Med Bras (1992). 2017 Mar;63(3):248-251
pubmed: 28489131
Mayo Clin Proc. 2001 Sep;76(9):897-905
pubmed: 11560300
Transl Res. 2007 Oct;150(4):197-214
pubmed: 17900507
Ann Thorac Surg. 2009 May;87(5):1469-74
pubmed: 19379886
Biol Psychiatry. 2016 Jul 1;80(1):40-52
pubmed: 26140821
Crit Care Med. 2013 Mar;41(3):800-9
pubmed: 23314584
Behav Neurosci. 2007 Feb;121(1):1-10
pubmed: 17324046
Ann Thorac Surg. 2005 Mar;79(3):1004-9
pubmed: 15734423
Biol Psychiatry. 2012 Jan 15;71(2):154-61
pubmed: 21967958
Br J Anaesth. 2015 Sep;115(3):427-33
pubmed: 26209856
J Neurosci. 2010 Oct 27;30(43):14356-60
pubmed: 20980591
Clin Neurophysiol. 2018 Jan;129(1):69-78
pubmed: 29154132
J Crit Care. 2015 Jun;30(3):606-12
pubmed: 25708120
Anesthesiology. 2012 Apr;116(4):788-96
pubmed: 22337162
J Clin Sleep Med. 2015 Aug 15;11(8):907-13
pubmed: 25979094
Crit Care. 2014 Sep 05;18(5):477
pubmed: 25189637
Anaesthesia. 2014 Jun;69(6):540-9
pubmed: 24813132
Surg Laparosc Endosc Percutan Tech. 2016 Dec;26(6):516-522
pubmed: 27846169
Curr Opin Neurobiol. 2017 Jun;44:178-185
pubmed: 28544930
Br J Anaesth. 1994 Nov;73(5):673-87
pubmed: 7826799
Front Neural Circuits. 2017 Sep 15;11:65
pubmed: 28966578
Sleep. 2004 Dec 15;27(8):1479-85
pubmed: 15683137
Sleep Med. 2016 Jan;17:87-98
pubmed: 26847980
J Am Geriatr Soc. 2017 May;65(5):949-957
pubmed: 28306148
Annu Rev Psychol. 2015 Jan 3;66:143-72
pubmed: 25061767
Crit Care Med. 2018 Dec;46(12):e1204-e1212
pubmed: 30222634