The prevalence and risk factors of sleep disturbances in surgical patients: A systematic review and meta-analysis

Nina Butris; Evan Tang; Bianca Pivetta; David He; Aparna Saripella; Ellene Yan; Marina Englesakis; Mark I Boulos; Mahesh Nagappa; Frances Chung

doi:10.1016/j.smrv.2023.101786

The prevalence and risk factors of sleep disturbances in surgical patients: A systematic review and meta-analysis

Sleep Med Rev. 2023 Jun:69:101786. doi: 10.1016/j.smrv.2023.101786. Epub 2023 Apr 19.

Authors

Affiliations

¹ Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, ON, Canada; Institute of Medical Science, University of Toronto, ON, Canada.
² Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, ON, Canada.
³ Faculty of Medicine, University of Ottawa, ON, Canada.
⁴ Department of Anesthesia and Pain Management, Mount Sinai Hospital, University Health Network, University of Toronto, ON, Canada.
⁵ Library & Information Services, University Health Network, ON, Canada.
⁶ Division of Neurology, Department of Medicine, University of Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, ON, Canada.
⁷ Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre and St. Joseph Healthcare, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
⁸ Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, ON, Canada; Institute of Medical Science, University of Toronto, ON, Canada. Electronic address: frances.chung@uhn.ca.

PMID: 37121133
DOI: 10.1016/j.smrv.2023.101786

Abstract

Determining the prevalence and risk factors related to sleep disturbance in surgical patients would be beneficial for risk stratification and perioperative care planning. The objectives of this systematic review and meta-analysis are to determine the prevalence and risk factors of sleep disturbances and their associated postoperative complications in surgical patients. The inclusion criteria were: (1) patients ≥18 years old undergoing a surgical procedure, (2) in-patient population, and (3) report of sleep disturbances using a validated sleep assessment tool. The systematic search resulted in 21,951 articles. Twelve patient cohorts involving 1497 patients were included. The pooled prevalence of sleep disturbances at preoperative assessment was 60% (95% Confidence Interval (CI): 50%, 69%) and the risk factors for postoperative sleep disturbances were a high preoperative Pittsburgh sleep quality index (PSQI) score indicating preexisting disturbed sleep and anxiety. Notably, patients with postoperative delirium had a higher prevalence of pre- and postoperative sleep disturbances and high preoperative wake after sleep onset percentage (WASO%). The high prevalence of preoperative sleep disturbances in surgical patients has a negative impact on postoperative outcomes and well-being. Further work in this area is warranted.

Keywords: Pittsburgh sleep quality index; Postoperative complications; Risk factors; Sleep disturbances; Surgery.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Anxiety
Humans
Prevalence
Risk Factors
Sleep Wake Disorders* / epidemiology
Sleep Wake Disorders* / etiology
Sleep*