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Lin J, Wang B, Zeng W, Zhuang S, Liu M, Yang J. Evidence-based interventions to improve sleep quality after thoracic surgery:A retrospective analysis of clinical studies. Sleep Med 2024; 121:85-93. [PMID: 38945038 DOI: 10.1016/j.sleep.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/14/2024] [Accepted: 06/06/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE To investigate and rank the evidence for the efficacy of interventions in improving sleep quality after cardiac surgery using comprehensive comparisons. BACKGROUND Clinical evidence suggests that over 80 % of adult cardiac surgery patients experience sleep disturbances during the first week postoperatively. While certain interventions have been shown to improve post-thoracic surgery sleep quality, a systematic description of the effects of these varied interventions is lacking. METHODS This systematic search was conducted across PubMed, Web of Science, Cochrane, Embase, and CINAHL databases to collate all published randomized clinical trials as evidence. Two researchers independently extracted pertinent information from eligible trials and assessed the quality of included studies. Based on statistical heterogeneity, traditional meta-analysis using fixed or random-effects models was employed to assess the efficacy of interventions, and a Frequentist network meta-analysis using a consistency model was conducted to rank the effectiveness of intervention protocols. RESULTS Our review incorporated 37 articles (n = 3569), encompassing 46 interventions, including 9 reports on pharmacological interventions (24.3 %), 28 on non-pharmacological interventions (75.7 %), and 5 on anesthetic management interventions (13.5 %). The analysis indicated the efficacy of Benson's relaxation technique, Progressive muscle relaxation, Education, Aromatherapy, Acupressure, Massage, and Eye masks in enhancing postoperative sleep quality. Specifically, Benson's relaxation technique (cumulative ranking curve area: 0.80; probability: 98.3 %) and Acupressure (cumulative ranking curve area: 0.96; probability: 58.3 %) were associated with the highest probability of successfully improving postoperative sleep quality, while Progressive muscle relaxation (cumulative ranking curve area: 0.70; probability: 35.2 %) and Eye masks (cumulative ranking curve area: 0.81; probability: 78.8 %) were considered secondary options. Eye masks and Massage significantly reduced postoperative sleep latency, with Eye masks (cumulative ranking curve area: 0.82; probability: 51.0 %) being most likely to enhance sleep quality postoperatively, followed by Massage (cumulative ranking curve area: 0.60; probability: 27.2 %). Education, Music, Massage, Eye masks, and Handholding were effective in alleviating pain intensity, with Education being most likely to successfully reduce postoperative pain (cumulative ranking curve area: 0.92; probability: 54.3 %), followed by Music (cumulative ranking curve area: 0.91; probability: 54 %). CONCLUSIONS Our findings can be utilized to optimize strategies for managing post-thoracic surgery sleep disturbances and to develop evidence-based approaches for this purpose. Benson's relaxation technique, Progressive muscle relaxation, Education, Aromatherapy, Acupressure, Massage, and Eye masks significantly improve sleep quality in postoperative patients. KEY: disorders of initiating and maintaining sleep, sleep wake disorders, thoracic surgical procedures, cardiac surgical procedures, sleep quality, pain, network meta-analysis.
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Affiliation(s)
- Jierong Lin
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China; College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Bitao Wang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China; College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Wanxian Zeng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China; College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Shaowei Zhuang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China; College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China; College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Jing Yang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China; College of Pharmacy, Fujian Medical University, Fuzhou, China.
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Yuan X, Ju Z, Zhang X, Yin X. Perioperative Sleep Disturbance in Surgical Patients: A Concept Analysis. Clin Nurs Res 2024:10547738241258509. [PMID: 38867492 DOI: 10.1177/10547738241258509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
To investigate and define the concept of perioperative sleep disturbance (PSD) among surgical patients, with the goal of aiding clinical practice and research. Walker and Avant's eight-step approach of concept analysis was applied. A systematic search of English literature was conducted in the following databases: PubMed, Web of Science, and CINAHL, with a time restriction from 2010 to August 2023. Based on the 54 eligible studies, the attributes of PSD in surgical patients were identified as individualized symptom manifestation, difficulty initiating and/or maintaining sleep, and altered sleep patterns. The antecedents included poor psychological state, inaccurate perception, surgery and/or anesthesia-related physiological changes, and environmental interference. PSD in surgical patients was found to result in physical discomfort, psychological disorder, impaired neurocognitive function, and prolonged recovery. A clearly defined and distinguishable concept of PSD in surgical patients was achieved through concept analysis, which provides a conceptual basis for future development in both clinical practice and related research.
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Affiliation(s)
- Xi Yuan
- The First Affiliated Hospital of Soochow University, Soochow, China
| | - Zhengyu Ju
- The First Affiliated Hospital of Soochow University, Soochow, China
| | - Xinmei Zhang
- The First Affiliated Hospital of Soochow University, Soochow, China
| | - Xuequn Yin
- The First Affiliated Hospital of Soochow University, Soochow, China
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Maghami M, Pour-Abbasi MS, Yadollahi S, Maghami M, Azizi-Fini I, Afazel MR. Pain and sleep after open-heart surgery-inhalation peppermint essence: double-blind randomized clinical trial. BMJ Support Palliat Care 2024; 13:e1318-e1325. [PMID: 37536755 DOI: 10.1136/spcare-2023-004214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the effect of inhaling peppermint essence on pain relief and sleep quality after open-heart surgery. METHODS In a double-blind randomised clinical trial carried out in Iran in 2020, 64 cardiac patients were selected by convenience sampling and randomly allocated to aromatherapy (n=32) and placebo (n=32) groups. The aromatherapy and control groups received inhaled aromatherapy using peppermint essence and distilled water, respectively. Data gathering tools were the Numeric Pain Rating Scale and St Mary's Hospital Sleep Questionnaire. Data were analysed using an independent t-test, χ2 test, Mann-Whitney U test and generalised estimating equation analysis. RESULTS The mean severity of pain in the aromatherapy and placebo groups was 3.22±0.88 and 4.56±0.90, respectively, which was a statistically significant difference (p=0.0001). The mean sleep scores after the intervention on day 1 were 20.10±4.90 and 25.76±6.36 in the aromatherapy and placebo groups, respectively, and 18.63±5.56 and 22.62±5.69, respectively, on day 2. The difference between the two groups was statistically significantly different after the intervention in terms of sleep quality (p<0.05). CONCLUSION Aromatherapy attenuated pain and improved sleep quality after open-heart surgery. Peppermint essence aromatherapy is therefore recommended after surgery.
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Affiliation(s)
- Mahla Maghami
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Safoura Yadollahi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahboobeh Maghami
- Biostatics and Epidemiology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ismail Azizi-Fini
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad-Reza Afazel
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Liu Y, Li Y, Liu M, Zhang M, Wang J, Li J. Effects of Acupuncture-Point Stimulation on Perioperative Sleep Disorders: A Systematic Review with Meta-Analysis and Trial Sequential Analysis. Int J Clin Pract 2024; 2024:6763996. [PMID: 38222288 PMCID: PMC10783988 DOI: 10.1155/2024/6763996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/01/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024] Open
Abstract
Background Perioperative sleep disorders exert a severe adverse impact on postoperative recovery. Recently, some observational studies reported that acupuncture-point stimulation (APS) provided benefits for promoting perioperative sleep quality. However, the effects of APS on perioperative sleep disorders following general anesthesia have not been thoroughly assessed by any systematic study and meta-analysis. Therefore, we conducted this systematic review and meta-analysis to reveal the effects of APS on perioperative sleep disorders. Methods Eight databases (Chinese: CNKI, VIP, CBM, and Wanfang; English: PubMed, Embase, Web of Science, and Cochrane Library) were thoroughly searched to find randomized controlled trials (RCTs) that indicated a link between APS and the occurrence of perioperative sleep disorders. We applied RevMan 5.4 (Cochrane Collaboration) and Stata 16.0 (Stata Corp) to conduct our meta-analysis. In addition, the trial sequential analysis (TSA) tool was utilized to estimate the validity and reliability of the data. Results In this study, nine RCTs with 719 patients were conducted. Compared to the control group, APS significantly improved perioperative subjective sleep quality (SMD: -1.36; 95% CI: -1.71 to -1.01; P < 0.00001). Besides, it increased perioperative TST (preoperative period MD = 24.29, 95% CI: 6.4 to 42.18, P = 0.0008; postoperative period MD = 45.86, 95% CI: 30.00 to 61.71, P < 0.00001) and SE (preoperative MD = 3.62, 95% CI: 2.84 to 4.39, P < 0.00001; postoperative MD = 6.43, 95% CI: 0.95 to 11.73, P < 0.00001). The consequence of trial sequential analysis further confirmed the reliability of our meta-analysis results. Conclusion According to the currently available evidence, APS could effectively improve perioperative sleep quality and play an essential role in decreasing the incidence of perioperative sleep disorders.
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Affiliation(s)
- Ying Liu
- Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, China
- Hebei Medical University, Shijiazhuang, China
| | - Yi Li
- Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, China
| | - Meinv Liu
- Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, China
| | - Meng Zhang
- Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, China
| | - Jing Wang
- Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, China
| | - Jianli Li
- Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, China
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Henríquez-Beltrán M, Benítez I, Belmonte T, Jorquera J, Jorquera-Diaz J, Cigarroa I, Burgos M, Sanhueza R, Jeria C, Fernandez-Bussy I, Nova-Lamperti E, Barbé F, Targa A, Labarca G. Association between Acute Respiratory Distress Syndrome Due to COVID-19 and Long-Term Sleep and Circadian Sleep-Wake Disorders. J Clin Med 2023; 12:6639. [PMID: 37892777 PMCID: PMC10607050 DOI: 10.3390/jcm12206639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/12/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Current studies agree on the impact of sleep and circadian rest-activity rhythm alterations in acute respiratory distress syndrome (ARDS) survivors. However, research on the duration of this impact is scarce. In this study, we evaluate the impact of ARDS on the sleep and circadian rest-activity rhythm of COVID-19 survivors twelve months after hospital discharge. This is a prospective study including COVID-19 survivors with and without ARDS during hospitalization. Data was collected four and twelve months after hospital discharge. The interventions included one-week wrist actigraphy and a home sleep apnea test (HSAT), and evaluations were conducted according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), and insomnia severity index (ISI). Fifty-two patients were evaluated (ARDS = 31 and non-ARDS = 21); they had a median age of 49.0 [39.0;57.2] years and 53.8% were male. After twelve months, 91.3% presented poor sleep quality, 58.7% presented insomnia, 50% presented daytime somnolence, and 37% presented comorbid insomnia and obstructive sleep apnea (COMISA). No significant improvement was observed in relation to sleep or the circadian rest-activity rhythm between four and twelve months. A tendency of poor sleep quality, insomnia, daytime somnolence, and COMISA was observed. Finally, there was no significant impact on the circadian rest-activity rhythm between four and twelve months or between the groups.
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Affiliation(s)
- Mario Henríquez-Beltrán
- Núcleo de Investigación en Ciencias de la Salud, Universidad Adventista de Chile, Chillán 3780000, Chile;
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), 25198 Lleida, Spain; (I.B.); (T.B.); (F.B.); (A.T.)
| | - Iván Benítez
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), 25198 Lleida, Spain; (I.B.); (T.B.); (F.B.); (A.T.)
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Thalía Belmonte
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), 25198 Lleida, Spain; (I.B.); (T.B.); (F.B.); (A.T.)
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Jorge Jorquera
- Centro de Enfermedades Respiratorias, Clínica Las Condes, Facultad de Medicina, Universidad Finis Terrae, Santiago 7591047, Chile;
| | - Jorge Jorquera-Diaz
- Facultad de Ciencias Medicas, Universidad Favarolo, Buenos Aires C1079ABE, Argentina;
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (M.B.); (R.S.)
| | - Matías Burgos
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (M.B.); (R.S.)
| | - Rocio Sanhueza
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (M.B.); (R.S.)
| | - Claudia Jeria
- Área Transversal de Formación General, Unidad de Idiomas, Universidad Santo Tomás, Santiago 8370003, Chile;
| | - Isabel Fernandez-Bussy
- Departamento de Medicina, Facultad de Ciencias Medicas, Universidad Católica Argentina, Buenos Aires C1107AFB, Argentina;
| | - Estefania Nova-Lamperti
- Laboratorio de Inmunología Molecular y Traslacional, Departamento de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción 4070112, Chile;
| | - Ferrán Barbé
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), 25198 Lleida, Spain; (I.B.); (T.B.); (F.B.); (A.T.)
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Adriano Targa
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), 25198 Lleida, Spain; (I.B.); (T.B.); (F.B.); (A.T.)
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Gonzalo Labarca
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepción, Concepción 4070112, Chile
- Division of Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, USA
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Shih CY, Wang AY, Chang KM, Yang CC, Tsai YC, Fan CC, Chuang HJ, Thi Phuc N, Chiu HY. Dynamic prevalence of sleep disturbance among critically ill patients in intensive care units and after hospitalisation: A systematic review and meta-analysis. Intensive Crit Care Nurs 2023; 75:103349. [PMID: 36464604 DOI: 10.1016/j.iccn.2022.103349] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Sleep disturbance is a common complaint among critically ill patients in intensive care units and after hospitalisation. However, the prevalence of sleep disturbance among critically ill patients varies widely. OBJECTIVE To estimate the prevalence of sleep disturbance among critically ill patients in the intensive care unit and after hospitalisation. METHODS Electronic databases were searched from their inception until 15 August 2022. Only observational studies with cross-sectional, prospective, and retrospective designs investigating sleep disturbance prevalence among critically ill adults (aged ≥ 18 years) during intensive care unit stay and after hospitalisation were included. RESULTS We found 13 studies investigating sleep disturbance prevalence in intensive care units and 14 investigating sleep disturbance prevalence after hospitalisation, with 1,228 and 3,065 participants, respectively. The prevalence of sleep disturbance during an ICU stay was 66 %, and at two, three, six and ≥ 12 months after hospitalisation was 64 %, 49 %, 40 %, and 28 %, respectively. Studies using the Richards-Campbell Sleep Questionnaire detected a higher prevalence of sleep disturbance among patients in intensive care units than non-intensive care unit specific questionnaires; studies reported comparable sleep disturbance prevalence during intensive care stays for patients with and without mechanical ventilation. CONCLUSION Sleep disturbance is prevalent in critically ill patients admitted to an intensive care unit and persists for up to one year after hospitalisation, with prevalence ranging from 28 % to 66 %. The study results highlight the importance of implementing effective interventions as early as possible to improve intensive care unit sleep quality.
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Affiliation(s)
- Chun-Ying Shih
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - An-Yi Wang
- Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kai-Mei Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chi-Chen Yang
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ying-Chieh Tsai
- Department of Nursing, Cathay General Hospital, Taipei, Taiwan
| | - Chu-Chi Fan
- Department of Nursing, Cathay General Hospital, Taipei, Taiwan
| | - Han-Ju Chuang
- Department of Nursing, Cathay General Hospital, Taipei, Taiwan
| | - Nguyen Thi Phuc
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Nursing Department, Vinmec Times City Hospital, Vinmec HealthCare System, Hanoi, Viet Nam
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Guo X, Qin Z, Meng C, Lv J, Hu Y, Fei J, Liang L, Li J, Yuan T, Mei S, Tong Q. Investigation of the Sleep Quality Among Hospitalized Cardiovascular Patients Using Regression Models and Qualitative Comparative Analysis. Clin Nurs Res 2023; 32:580-588. [PMID: 36633212 DOI: 10.1177/10547738221148150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study aimed to explore the relationships between modifiable and non-modifiable factors that influence sleep quality in hospitalized patients with cardiovascular disease in China. This study design was cross-sectional and descriptive. This study involved a convenience sample of 242 patients hospitalized for cardiovascular issues. Hierarchical regression model and qualitative comparative analysis model were performed. Regression revealed that age and depression both had statistically significant effects on sleep quality. The combination of conditions with strongest predictive effect on sleep quality was male of younger age, high level of depression, high level of anxiety, and low level of social support. Other combinations with predictive power on sleep quality are as follows: (1) younger male patients (aged 47-63 years) with high level of anxiety, high level of social support, and low level of depression; (2) older male patients (aged 63-79 years) with high level of depression, high level of social support, and low levels of anxiety; and (3) older male patients with high level of anxiety and low level of social support. Nurses may promote primary and secondary prevention of cardiovascular health prior to hospitalization, through routine screening for depressive and anxious symptoms and assessment of the patient's social support network. It is unknown whether these findings are unique to hospitalized patients. Therefore, future work should assess the fit of the model to other more diverse groups of hospitalized patients.
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Affiliation(s)
- Xinmeng Guo
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Zeying Qin
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Cuicui Meng
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jianping Lv
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yueyang Hu
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Junsong Fei
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Leilei Liang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jingyang Li
- First Hospital, Jilin University, Changchun, Jilin Province, China
| | - Tongshuang Yuan
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Songli Mei
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Qian Tong
- First Hospital, Jilin University, Changchun, Jilin Province, China
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Hu XM, Wei WT, Huang DY, Lin CD, Lu F, Li XM, Liao HS, Yu ZH, Weng XP, Wang SB, Hou CL, Jia FJ. Sleep patterns and potential risk factors for disturbed sleep quality in patients after surgery for infective endocarditis. J Cardiothorac Surg 2022; 17:121. [PMID: 35581652 PMCID: PMC9116038 DOI: 10.1186/s13019-022-01828-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background The current study aimed to investigate the sleep quality of patients after valve replacement surgery due to infective endocarditis and identify risk factors for disturbed sleep post hospitalisation. Methods Eighty patients were assessed postoperatively using subjective scale measures, the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale, and an objective measure, actigraphy. Scale measures were assessed approximately 2 weeks and 6 months after surgery. Actigraphy monitoring was performed for 2 consecutive weeks during hospitalisation. Logistic regression was used to identify risk factors for disturbed sleep. Results The study population (n = 80) had an average age of 42.8 ± 14.2 years, and 67.5% were male. The median sleep efficiency was 85.3% in week 1 and 86.8% in week 2. The frequency of awakenings was significantly higher in week 1 (20.0 times vs. 19.3 times, p = 0.017). The scale measures showed significant improvement in sleep by 6 months after surgery compared to that during hospitalisation. Multivariable logistic regression analysis suggested that the possible risk factors for disturbed sleep 6 months after surgery included age (OR = 1.479, 95%CI 1.140–1.920) and a few parameters of early postoperative disturbed sleep quality (PSQI: OR = 2.921, 95%CI 1.431–5.963; sleep efficiency: OR = 0.402, 95%CI 0.206–0.783; and average duration of awakenings: OR = 0.006, 95%CI 0.000–0.827). Conclusions Disturbed sleep quality was witnessed in postoperative patients during hospitalisation and up to 6 months after surgery. Over time, the patients’ sleep quality improved significantly. Age and a few early postoperative sleep quality variables were risk factors for disturbed sleep 6 months after surgery. Supplementary Information The online version contains supplementary material available at 10.1186/s13019-022-01828-4.
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Affiliation(s)
- Xiang-Ming Hu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Wen-Ting Wei
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - De-Yi Huang
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Cai-Di Lin
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Fen Lu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Xiao-Ming Li
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Huo-Sheng Liao
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Zhi-Hong Yu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Xiao-Ping Weng
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China
| | - Fu-Jun Jia
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China. .,Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China.
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Elliott R, Axelin A, Richards KC, Vahlberg T, Ritmala‐Castren M. Sensitivity and specificity of proposed Richards‐Campbell Sleep Questionnaire cut‐off scores for good quality sleep during an ICU stay. J Clin Nurs 2022; 32:2700-2708. [PMID: 35570380 DOI: 10.1111/jocn.16348] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The 5-visual analogue scale Richards-Campbell Sleep Questionnaire subjective sleep measure is widely used in intensive care. A cut-off score indicative of good quality sleep has not been established and is required to guide the categorisation of individual patient and unit wide sleep quality. DESIGN AND METHODS The aim was to determine the global Richards-Campbell Sleep Questionnaire cut-off score for good to very good sleep during an intensive care unit stay in non-ventilated patients. The study was a secondary (cohort) retrospective analysis of patient self-report data (n = 32) from an interventional study testing a sleep promotion bundle. The Standards for Reporting Diagnostic Accuracy studies statement were used to report the study. The study was conducted in two mixed adult 12 and 20-bed ICUs of a tertiary referral hospital in a metropolitan area. In the morning, eligible patients were administered the Richards-Campbell Sleep Questionnaire together with a 5-category item Likert scale in which patients rated their nocturnal sleep quality as 'very poor', 'poor', 'fair', 'good' and 'very good'. Receiver Operator Curve analysis was performed. RESULTS Thirty-seven per cent (n = 32) of the total sample of 84 adult intensive care patients were females. The median age was 61.5 (51, 72) years. Self-reported median global Richards-Campbell Sleep Questionnaire score was 54.4 (30.1, 77.1) mm. A global score of ≥63.4 mm was the optimal cut-off for self-reported 'good sleep' (sensitivity: 87%, specificity: 81% and area under the curve: 0.896). CONCLUSIONS Although the study requires replication in ventilated patients and other ICU settings, the cut-off score (63 mm) could be used to guide the categorisation of individual patient and unit wide sleep quality.
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Affiliation(s)
- Rosalind Elliott
- Nursing and Midwifery Centre Nursing and Midwifery Directorate Northern Sydney Local Health District St Leonards NSW Australia
- School of Nursing and Midwifery Faculty of Health University of Technology Sydney NSW Australia
| | - Anna Axelin
- Department of Nursing Science University of Turku Turku Finland
| | | | - Tero Vahlberg
- Department of Biostatistics University of Turku Turku Finland
| | - Marita Ritmala‐Castren
- Department of Nursing Science University of Turku Turku Finland
- Nursing Administration Helsinki University Hospital Helsinki Finland
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10
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Comparative efficacy of nonpharmacological interventions on sleep quality in people who are critically ill: A systematic review and network meta-analysis. Int J Nurs Stud 2022; 130:104220. [DOI: 10.1016/j.ijnurstu.2022.104220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 11/19/2022]
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11
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Delaney LJ, Litton E, Huang HCC, Lopez V, van Haren FMP. The accuracy of simple, feasible alternatives to polysomnography for assessing sleep in intensive care: An observational study. Aust Crit Care 2022; 36:361-369. [PMID: 35361553 DOI: 10.1016/j.aucc.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/06/2022] [Accepted: 02/06/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Sleep disturbance is common in intensive care patients. Understanding the accuracy of simple, feasible sleep measurement techniques is essential to informing their possible role in usual clinical care. OBJECTIVE The aim of the study was to investigate whether sleep monitoring techniques such as actigraphy (ACTG), behavioural assessments, and patient surveys are comparable with polysomnography (PSG) in accurately reporting sleep quantity and quality among conscious, intensive care patients. METHODS An observational study was conducted in 20 patients admitted to the intensive care unit (ICU) for a minimum duration of 24 h, who underwent concurrent sleep monitoring via PSG, ACTG, nursing-based observations, and self-reported assessment using the Richards-Campbell Sleep Questionnaire. RESULTS The reported total sleep time (TST) for the 20 participants measured by PSG was 328.2 min (±106 min) compared with ACTG (362.4 min [±62.1 min]; mean difference = 34.22 min [±129 min]). Bland-Altman analysis indicated that PSG and ACTG demonstrated clinical agreement and did not perform differently across a number of sleep variables including TST, awakening, sleep-onset latency, and sleep efficiency. Nursing observations overestimated sleep duration compared to PSG TST (mean difference = 9.95 ± 136.3 min, p > 0.05), and patient-reported TST was underestimated compared to PSG TST (mean difference = -51.81 ± 144.1 7, p > 0.05). CONCLUSIONS Amongst conscious patients treated in the ICU, sleep characteristics measured by ACTG were similar to those measured by PSG. ACTG may provide a clinically feasible and acceptable proxy approach to sleep monitoring in conscious ICU patients.
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12
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Seid Tegegne S, Fenta Alemnew E. Postoperative poor sleep quality and its associated factors among adult patients: A multicenter cross-sectional study. Ann Med Surg (Lond) 2022; 74:103273. [PMID: 35145662 PMCID: PMC8819123 DOI: 10.1016/j.amsu.2022.103273] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/09/2022] [Accepted: 01/23/2022] [Indexed: 12/12/2022] Open
Abstract
Background Sleep quality refers to a sense of being refreshed and rested after waking up from sleep. Postoperative patients were vulnerable to poor sleep quality due to having different contributing factors. The prevalence of poor sleep quality among postsurgical patients was left undisclosed in our study setting. Knowing the prevalence and contributing factors for poor sleep quality helps us to develop a strategic plan for prevention and management. Method and materials A multicenter cross-sectional study design was conducted on 424 postsurgical patients who were selected by a systematic random sampling method. Data was collected using the Pittsburgh Sleep Quality Index by a face-to-face interview. Data analysis was done using SPSS version 25. For categorical data, a chi-square test was done. Bivariable and multivariable analyses were performed to determine whether each of the independent variables is associated with the outcome variable. Result Based on this study result, the prevalence of poor sleep quality was 64.9%. Among the factors included in this study, variables which had an association with poor postoperative sleep quality were age range 25–54 years (AOR = 15.13), male gender (AOR = 4.81), educational level of secondary school (AOR = 6.29), patient income less than 2500 birr (AOR = 3.77), anxiety (AOR = 2.53), depression(AOR = 22.8), light exposure(AOR = 19.60), poor social support (AOR = 1.98), being emergency surgery (AOR = 2.46) and having a history of moderate to severe pain (AOR = 38.18, (95% CI). Conclusion Poor sleep quality among adult post-surgical patients was significantly high in Amhara regional comprehensive referral hospitals. Therefore; Clinicians need to prioritize postoperative sleep quality assessment and needs to minimize factors inducing postoperative sleep disturbances. The prevalence of postoperative poor sleep quality was 64.9%. Pain is associated with poor sleep qualities. Postoperative sleep quality was poorly managed.
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Affiliation(s)
- Shimelis Seid Tegegne
- Department of Anesthesia, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Efrem Fenta Alemnew
- Department of Anesthesia, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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13
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Hu XM, Wei WT, Huang DY, Lin CD, Lu F, Li XM, Liao HS, Yu ZH, Weng XP, Wang SB, Hou CL, Jia FJ. The Assessment of Sleep Quality in Patients Following Valve Repair and Valve Replacement for Infective Endocarditis: A Retrospective Study at a Single Center. Med Sci Monit 2021; 27:e930596. [PMID: 34433799 PMCID: PMC8406810 DOI: 10.12659/msm.930596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The aim of this study was to measure sleep quality among patients who underwent infective endocarditis (IE) surgery and identify the risk factors involved in sleep disorders. Material/Methods In this study, we used actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleep Scale (ESS) to determine the clinical characteristics of sleep disorders in 116 patients with IE who were in rehabilitation after surgery. Results Our results showed that 46 (39.7%) patients had sleep efficiency over 85%, while 70 (60.3%) patients had sleep efficiency below 85%. The correlation analysis showed that sleep efficiency was related to the duration of the disease, with a longer duration leading to lower sleep efficiency (P=0.031). The sleep efficiency of patients with IE following surgery was also affected by alcohol consumption; however, surprisingly, patients with “heavy” alcohol consumption had higher sleep efficiency (P=0.030). We found a significant correlation between sleep efficiency and postoperative interleukin-6 (IL) levels, C-reactive protein (CRP) levels, and preoperative erythrocyte sedimentation rate (P<0.05). No significant correlation was found between brain natriuretic peptide levels and sleep efficiency, PSQI score, or ESS score. Postoperative hemoglobin (Hb) level was associated with sleep efficiency (R=0.194, P=0.036), but there was no statistically significant correlation between the PSQI and ESS scores. Postoperative alanine transaminase (ALT) showed a significant negative correlation with sleep efficiency (R=−0.27, P=0.003). Conclusions We found a high prevalence of sleep disorders in patients with IE along with an increase in inflammatory factors, including postoperative IL-6, CRP, ALT, and Hb levels.
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Affiliation(s)
- Xiang-Ming Hu
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China (mainland).,Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Wen-Ting Wei
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - De-Yi Huang
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Cai-Di Lin
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Fen Lu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Xiao-Ming Li
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Huo-Sheng Liao
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Zhi-Hong Yu
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Xiao-Ping Weng
- Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - Fu-Jun Jia
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China (mainland).,Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
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14
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Lin D, Huang X, Sun Y, Wei C, Wu A. Perioperative Sleep Disorder: A Review. Front Med (Lausanne) 2021; 8:640416. [PMID: 34164409 PMCID: PMC8215143 DOI: 10.3389/fmed.2021.640416] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/13/2021] [Indexed: 12/28/2022] Open
Abstract
Patients in the perioperative period usually present with different types and degrees of sleep disorders, which can severely affect their post-operative outcomes. Multiple risk factors may lead to the occurrence of perioperative sleep disorders, including personal factors, psychological factors, surgery factors, and environmental factors. In this review, we summarize the potential risk factors for perioperative sleep disorders during hospitalization. And it also provides an overview of perioperative outcomes and potential therapeutic prevention of perioperative sleep disorders. However, the further search is necessary to investigate the effectiveness and safety of preventions in the clinical practice and push forward the therapies.
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Affiliation(s)
- Dandan Lin
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiao Huang
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yi Sun
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Changwei Wei
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Anshi Wu
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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15
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Ritmala-Castren M, Axelin A, Richards KC, Mitchell ML, Vahlberg T, Leino-Kilpi H. Investigating the construct and concurrent validity of the Richards-Campbell Sleep Questionnaire with intensive care unit patients and home sleepers. Aust Crit Care 2021; 35:130-135. [PMID: 34049774 DOI: 10.1016/j.aucc.2021.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 03/16/2021] [Accepted: 04/17/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Sleep is vital to our wellbeing. Critically ill patients are vulnerable with effects of sleep deprivation including weakened immune function, decreased glucose tolerance, and increased sympathetic activity. Intensive care unit (ICU) patients' sleep evaluation is difficult and often not reliable. The most commonly used instrument for assessing ICU patients' perspective of their sleep, Richards-Campbell Sleep Questionnaire (RCSQ), has not been reported to have undergone known-group construct validity testing or concurrent validity testing with the criterion measure of feeling refreshed. OBJECTIVES The aim of the study was to explore the construct validity of the RCSQ with known-groups technique and concurrent validity with the criterion measure of feeling refreshed on awakening. METHODS A cross-sectional descriptive survey study using the RCSQ was conducted on people sleeping at home (n = 114) over seven nights. The results were compared with the RCSQ sleep scores of nonintubated alert oriented adult ICU patients (n = 114). Home sleepers were also asked to rate how refreshed they felt on awakening. The study was executed and reported in accordance with the STROBE checklist for observational studies. FINDINGS RCSQ construct validity was supported because home sleepers' and ICU sleepers' sleep evaluations differed significantly. Home sleepers rated their sleep significantly better than ICU patients in all five sleep domains of the RCSQ. Concurrent validity was supported because the item "feeling refreshed on awakening" correlated strongly with all sleep domains. CONCLUSIONS Sleep quality may be accurately measured using the RCSQ in alert people both in the ICU and at home. This study has added to the validity discussion around the RCSQ. The RCSQ can be used for sleep evaluation in ICUs to promote wellbeing and recovery.
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Affiliation(s)
- Marita Ritmala-Castren
- Helsinki University Hospital, Po BOX 100, FI-00029 HUS, Finland; Department of Nursing Science, University of Turku, FI-20014 TURUN YLIOPISTO, Finland.
| | - Anna Axelin
- Department of Nursing Science, University of Turku, FI-20014 TURUN YLIOPISTO, Finland.
| | - Kathy C Richards
- University of Texas at Austin, School of Nursing, 1710 Red River St., Austin, TX 78712, USA.
| | - Marion L Mitchell
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, N48 2.14, Nathan Campus, 170 Kessels Road, Nathan, Queensland 4111, Australia; Princess Alexandra Hospital Intensive Care Unit, 199 Ipswich Rd, Woolloongabba, Queensland 4102, Australia.
| | - Tero Vahlberg
- Department of Biostatistics, University of Turku, FI-20014 TURUN YLIOPISTO, Finland.
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, FI-20014 TURUN YLIOPISTO, Finland; Turku University Hospital, PO Box 52, FI-20521 TURKU, Finland.
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16
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Intensive Care Unit Environment and Sleep. Crit Care Nurs Clin North Am 2021; 33:121-129. [PMID: 34023080 DOI: 10.1016/j.cnc.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients undergoing treatment in intensive care unit are in an extremely vulnerable state and require a complex multidisciplinary approach. Adequate sleep is required to maintain physiologic functions of the human body. Good sleep quality plays a vital role in the process of recovery. Sleep disruption in intensive care settings is a well-known fact. The consequences of sleep deprivation can cause numerous complications including delayed mechanical ventilation wean, neurocognitive dysfunction, decreased immune function and increased mortality rates. This review describes how the intensive care unit environment impacts sleep architecture.
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17
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Le Grande MR, Jackson AC, Beauchamp A, Kerr D, Driscoll A. Diagnostic accuracy and suitability of instruments that screen for obstructive sleep apnoea, insomnia and sleep quality in cardiac patients: a meta-analysis. Sleep Med 2021; 86:135-160. [PMID: 33674192 DOI: 10.1016/j.sleep.2021.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND A number of clinical guidelines recommend that all cardiac rehabilitation patients should be screened for potential sleep disorders with a validated screening instrument. There is currently no consensus on what specific tools should be used. OBJECTIVE To identify tools that are practical to use in the clinical environment and have high diagnostic accuracy. METHODS We systematically searched online databases to identify patient reported outcome instruments that have been used in published research studies to assess the likelihood of obstructive sleep apnoea (OSA) in cardiac patients. In studies that provided diagnostic data, these data were extracted and verified via an evidence-based diagnostic calculator. Where sufficient numbers of studies were available, a meta-analysis was conducted to determine pooled estimates of specificity, sensitivity and diagnostic odds ratios. Selected papers were qualitatively assessed using the Standards for Reporting Diagnostic accuracy studies (STARD). RESULTS Of the 21 instruments identified, six detected likelihood of OSA, two assessed daytime sleepiness, five assessed insomnia and eight examined sleep quality. A meta-analysis of 14 studies that assessed diagnostic accuracy of moderate OSA, revealed moderate sensitivity for the Berlin Questionnaire, Sens = 0.49 (95% CI 0.45-0.52) and good sensitivity for the Stop-BANG, Sens = 0.93 (95% CI 0.87-0.96) but poor specificity at standard cut-off criteria. CONCLUSION There are promising practical tools available to screen patients with OSA and other sleep disorders in cardiac rehabilitation settings, but specificity could be improved. Additional assessment of sleep quality may enhance prognostic ability with both OSA and insomnia screening.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Melbourne Centre for Behaviour Change, School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Alun C Jackson
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Centre on Behavioural Health, Hong Kong University, Pakfulam, Hong Kong
| | - Alison Beauchamp
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Department of Medicine - Western Health, The University of Melbourne, VIC, 3052, Australia; Australian Institute for Musculoskeletal Science (AIMSS), St. Albans, VIC, 3021, Australia; School of Rural Health, Monash University, Newborough, VIC, 3825, Australia
| | - Debra Kerr
- Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia
| | - Andrea Driscoll
- Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
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18
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Efficacy of Valerian Extract on Sleep Quality after Coronary Artery bypass Graft Surgery: A Triple-Blind Randomized Controlled Trial. Chin J Integr Med 2021; 27:7-15. [PMID: 33420602 DOI: 10.1007/s11655-020-2727-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess the effect of valerian root extract on the sleep quality of patients after coronary artery bypass graft (CABG) surgery. METHODS The patients who participated in this triple-blind clinical trial were selected by permuted block randomization. The participants were assigned to the valerian (n=36) and placebo (n=36) groups. The valerian group received 530 mg of valerian capsules for 30 nights after CABG surgery, and the placebo group received 530 mg of the placebo capsules containing wheat flour. The Pittsburgh Sleep Quality Index (PSQI), the prothrombin time (PT) and partial thromboplastin time (PTT) were assessed on four occasions, including the baseline, the 3rd, 14th and 30th days following intervention. RESULTS The odds ratio of worsened sleep quality significantly varied over time (the interaction of time and group) in the valerian group compared to the placebo group in various dimensions including total sleep quality (P=0.001), sleep latency (P<0.01), sleep duration (P=0.020), sleep efficiency (P=0.001) and daytime dysfunction (P=0.025). No significant difference was observed in the alterations of the odds ratio of PT in the two groups over time. (P=0.371). CONCLUSION The consumption of oral valerian root extract over 30 nights could significantly improve the patients' sleep quality safely after CABG surgery.
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19
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Yazdani A, Samimi Ardestani SM, Azargashb E, Najarzadegan MR, Kohansal K, Salehabadi G, Sadr SS. Comparisons between Insomnia Incidence after Coronary Artery Bypass Graft Surgery with Coronary Angioplasty. Adv Biomed Res 2020; 9:69. [PMID: 33816388 PMCID: PMC8012862 DOI: 10.4103/abr.abr_221_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background: The aim of this study was to investigate the incidence of insomnia after coronary angioplasty and coronary artery bypass graft surgery (CABG) and compare them. Materials and Methods: This cross-sectional study was done in Masih Daneshvari and Emam Hossein Hospital of Tehran during a period of 12 months in 2016. The study group consisted of patients who were admitted to these hospitals with heart disease and had to go under CABG or angioplasty. Each participant completed a detailed Persian version of the insomnia severity index and demographic questionnaire which includes demographic questions and questions about the onset or durability of sleep as well as questions about the use of alcohol, caffeine, cigarettes, and sleeping drugs 2 days before the surgery and 1 week after that. The state of insomnia was measured before and after the CABG and compared with the state of insomnia before and after angioplasty. Results: About 150 patients were included in the study (80 men [67.4%] and 70 women [43.6%]). In the CABG group, 14.67% of the preoperative patients and 24.0% of the patients after the operation had insomnia, and the difference between them was significant (P = 0.003). Furthermore, in the angioplasty group, 14.67% of the preoperative patients and 20.0% of the patients after the operation had insomnia, and the difference between them was significant (P = 0.001). Conclusion: Insomnia after both CABG and angioplasty was significantly increased but in CABG group this increase was more than angioplasty.
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Affiliation(s)
- Aram Yazdani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed Mehdi Samimi Ardestani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Eznollah Azargashb
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Kiarash Kohansal
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Salehabadi
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sayed Saeed Sadr
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Self-reported sleep quality and depression in post myocardial infarction patients attending cardiology outpatient clinics in Oman. Int J Nurs Sci 2019; 6:371-377. [PMID: 31728388 PMCID: PMC6838964 DOI: 10.1016/j.ijnss.2019.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 06/06/2019] [Accepted: 06/18/2019] [Indexed: 12/17/2022] Open
Abstract
Objective This study aimed to examine the sleep quality and prevalence of depression in post myocardial infarction patients attending cardiology outpatient clinics of selected hospitals in Oman. Methods A descriptive cross-sectional design was used to collect data from patients (n = 180) who were at least 4 weeks post myocardial infarction diagnosis and receiving follow-up care in the outpatient clinic. The Arabic version of the Pittsburgh Sleep Quality Index and Patient Health Questionnaire-9 were used to assess sleep quality and depressive symptoms, respectively. Results The sample mean age was 62.0 ± 11.3 years. Poor sleep quality affected 61.1% of the participants. The significant predictors of poor sleep quality were gender (P ≤ 0.05), body mass index (P ≤ 0.05), and self-reported regular exercise (P ≤ 0.01). The most impacted domains of sleep quality were sleep latency, sleep duration, and sleep disturbances. The prevalence of major depression was low (5%) and the rate of re-infarction was 27.2%. The prevalence of minimal to mild major depression with a potential of transitioning into major depression overtime was very high. Self-reported regular exercise (P ≤ 0.01) was the only significant predictor of depressive symptoms. Conclusion The sleep quality of post myocardial infarction patients was poor and the prevalence of depression was low. There was no significant relationship between sleep quality or depression with re-infarction.
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