Cardiac patients often experience sleep problems and reduced physical activity (PA) after cardiac surgery. Sleep and PA are known to have a reciprocal interaction, but their temporal dynamic relationship remains unexplored in this population.
Objective:
This study aimed to examine the temporal bidirectional relationship between sleep and PA after cardiac surgery using a cross-lagged panel model (CLPM).
Methods:
This exploratory, longitudinal study involved a secondary analysis of previous data. The sample consisted of 33 adults who had undergone open-heart surgery at least 10 weeks prior. Five sleep and four PA variables were measured over 7 days using a wrist-worn ActiGraph. Data were analyzed using CLPM.
Results:
Participants (mean age = 60.8 ± 10.1 years) had undergone cardiac surgery an average of 85.7 ± 91.2 months previously. The most common surgery type was coronary artery bypass grafting. Mean total sleep time was 6.4 ± 1.2 hours, below the recommended average of 7 hours, while average moderate-to-vigorous PA (117.8 ± 70.3 min/day) exceeded US guidelines. CLPM revealed unidirectional causation between sleep and PA; improved sleep efficiency predicted higher kilocalories expended and lower sedentary time the next day, while no PA predicted subsequent sleep.
Conclusions:
Improving sleep quality may enhance postsurgery PA, emphasizing the importance of integrated strategies targeting both behaviors in clinical and home-based rehabilitation programs. Future studies should explore the temporal dynamics between sleep and PA with a larger sample at different time points after surgery, while incorporating relevant covariates and mediators to deepen the understanding of these complex interactions.
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