1144 Relationship Between Sleep and Postoperative Delirium in Cardiac Surgeries: A Scoping Review
Year: 2025
Type: article
Study design: Systematic Review
Abstract: Introduction Perioperative sleep disturbance is a risk factor for postoperative delirium (POD). The two-fold aim of this study is to: evaluate the relationship between perioperative sleep disturbance and POD after cardiac surgeries (CS); and examine sleep recovery after cardiac surgeries in patients with and without POD. Methods We followed the Arksey and O’Malley framework for scoping review. Following the PRISMA statement and using keywords, we electronically searched five different electronical databases (PubMed, Cumulated Index to Nursing and Allied Health Literature, Web of Science, Scopus, EMBASE). The search was conducted in July 2024 with no date limitation. Original English articles that assessed sleep and POD in patients who had CS were eligible. Results Of the 14 included studies (28.5% interventional), most studies were from Iran (29%) followed by China (29%) and the US (21%). Reports indicated that the incidence of POD ranged from 5.3% to 50%. Patients who developed POD during hospitalization had significantly higher postoperative self-reported sleep disturbances after 3 years. Also, POD patients had a significantly higher Pittsburg Sleep Quality index (>5) one year after surgery. Preoperatively, high apnea-hypopnea index, low sleep efficiency, short sleep duration, and a high non-rapid eye movement arousal index predicted POD, indicating patients with poor sleep quality and insomnia are more likely to develop POD after CS. Although dexmedetomidine (an anesthetic) did not improve sleep quality 30, 60, 90, and 180 days after surgery compared to a placebo, it did help prevent POD. However, melatonin (3 mg) improved sleep quality when compared to Oxazepam (10 mg) after surgery. Conclusion Poor sleep quality and insomnia are the most common perioperative sleep disturbances and risk factors for POD. Melatonin improved post-surgery (in hospital) sleep quality but had no impact on POD. In contrast, dexmedetomidine prevented POD but did not improve post-hospital discharge sleep quality. Patients may need at least one month to achieve preoperative sleep quality, which may not necessarily be classified as good-quality sleep. Therefore, full sleep recovery may take 3 to 6 months post-CS. More research on the effectiveness of non-pharmacological interventions targeting sleep improvement, such as earplugs and eye masks after surgery, is warranted. Support (if any)
Source: SLEEP
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410501068