Premium
A polysomnography study examining the association between sleep and postoperative delirium in older hospitalized cardiac surgical patients
Author(s) -
Ibala Reine,
Mekonnen Jennifer,
Gitlin Jacob,
Hahm Eunice Y.,
Ethridge Breanna R.,
Colon Katia M.,
Marota Sophia,
Ortega Cristy,
Pedemonte Juan C.,
Cobanaj Marisa,
Chamadia Shubham,
Qu Jason,
Gao Lei,
Barbieri Riccardo,
Akeju Oluwaseun
Publication year - 2021
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.13322
Subject(s) - delirium , polysomnography , medicine , sleep (system call) , association (psychology) , cardiac surgery , anesthesia , psychiatry , electroencephalography , psychology , cardiology , computer science , psychotherapist , operating system
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.