The Effect of Sleep Disruption on Postoperative Pain

Abstract

Objectives:

(1) Identify the amount of sleep disruption that occurs in the postoperative inpatient hospital setting. (2) Determine the relationship between sleep disruption and the use of postoperative narcotic for pain. (3) Determine if the postoperative hospital course is impacted by sleep disruption. Sleep disturbance is a common complaint among hospitalized patients. Decreased sleep and poor sleep quality have been found to be correlated with poor hospital outcomes and decreased wound healing.

Methods:

Prospective cohort study. Fifty patients undergoing total hip or knee arthroplasty at Henry Ford Hospital in Detroit, Michigan, between January 2013 and November 2013 were asked to wear an actigraph during their postoperative hospital stay. Total sleep time, sleep efficiency, awake index, narcotic use, visual analog pain scores, and postoperative complications were analyzed.

Results:

A significant correlation was found between lower self-reported pain scores and total sleep time (P =.03). Spearman correlations between the number of minutes of sleep, sleep efficiency, and awake index were made with the narcotic use on postoperative days (PODs) 0 and 1. None of the results were statistically significant. Narcotic use on POD 0 and sleep on POD 1was marginally significant (P = .09). Longer hospital stay was associated with decreased sleep efficiency (P = .01). Complication rates were not statistically different when compared to other sleep parameters.

Conclusions:

Better control of a patient’s pain improves sleep efficiency and total sleep time. Attention to decreased sleep disruption for hospitalized patients has the potential to improve patient satisfaction with hospital care and decrease length of stay.