Factors associated with postoperative sleep disturbance in patients undergoing thoracoscopic radical resection for lung cancer: a retrospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Postoperative sleep disturbance (PSD) is common in patients following surgery, resulting in severe cognitive and mood disturbances, and even increase mortality risk. This study aimed to identify factors associated with PSD in patients undergoing thoracoscopic radical resection for lung cancer.Methods: We retrospectively identified sixty-two patients who underwent thoracoscopic radical resection of lung cancer at Tangdu Hospital, a tertiary teaching hospital in Xi’an, China, from June 2023 through October 2024. PSD was defined as a Richards-Campbell Sleep Questionnaire (RCSQ) score <60 on postoperative day 2 (POD2). Preoperative sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured using the Numeric Rating Scale (NRS) at rest and during coughing on POD1 and POD2. intraoperative fluid volume, and POD2 cough-induced pain, selected a priori based on clinical relevance and prior evidence. Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with PSD.Results: Of 62 patients (mean age 67.5 years; 45.2% female), 36 (58.1%) met the RCSQ-defined criteria for PSD on POD2. Three factors were independently associated with PSD: preoperative PSQI score [odds ratio (OR) =1.58, 95% confidence interval (CI): 1.19–2.10, P=0.001], intraoperative fluid volume (OR =1.004 per mL, 95% CI: 1.001–1.007, P=0.02), and POD2 cough-induced pain (OR =2.23 per point, 95% CI: 1.36–3.66, P=0.001). The model demonstrated good calibration (Hosmer-Lemeshow P=0.10) and discrimination (Nagelkerke R2=0.652).Conclusions: Preoperative sleep quality, intraoperative fluid volume, and POD2 cough-induced pain were independently associated with PSD in this cohort. These exploratory findings highlight the importance of closer assessment of potentially high-risk patients, but require validation in larger prospective studies before being translated into definitive preventive strategies.
Source: Journal of Thoracic Disease
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W7224104581