A polysomnography study examining the association between sleep and postoperative delirium in older hospitalized cardiac surgical patients.
A polysomnography study examining the association between sleep and postoperative delirium in older hospitalized cardiac surgical patients.
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DOI：
10.1111/jsr.13322
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发表时间：
2021-10
影响因子：
4.4
通讯作者：
Akeju O
中科院分区：
文献类型：
--
作者：
Ibala R;Mekonnen J;Gitlin J;Hahm EY;Ethridge BR;Colon KM;Marota S;Ortega C;Pedemonte JC;Cobanaj M;Chamadia S;Qu J;Gao L;Barbieri R;Akeju O
接受体外循环心脏手术的住院老年患者容易出现术后谵妄。自我报告的较短睡眠和较长睡眠与认知受损有关。很少有数据可以指导我们了解较短或较长的睡眠是否与该住院队列中术后谵妄有关。这是一项前瞻性、单中心、观察性研究，对象是计划接受体外循环择期重大心脏手术的住院患者（> 60 岁）（n = 16）。我们使用 Somté PSG 设备收集和分析夜间多导睡眠图数据，并使用长版本的混乱评估方法和结构化图表审查每天两次评估谵妄情况，直到术后第 3 天。我们还使用匹兹堡睡眠质量指数评估了主观睡眠质量。谵妄术前住院时间中位数为 9 [Q1, Q3: 7, 11] 天，与非谵妄术前住院时间 7 [4, 9] 天相似 (p = .154)。整个研究队列中谵妄的发生率为 45.5% (10/22)，在具有干净多导睡眠图数据的最终队列中谵妄发生率为 50% (8/16)。术前谵妄的中位总睡眠时间为 323.8 [Q1, Q3: 280.3, 382.1] 分钟，长于非谵妄的中位总睡眠时间 254.3 [210.9, 278.1] 分钟 (p = .046)。这是由于谵妄中位非快速眼动 (REM) 2 阶段睡眠持续时间较长，为 282.3 [229.8, 328.8] 分钟，而非谵妄中位非快速眼动 (REM) 2 阶段睡眠持续时间为 202.5 [174.4, 208.9] 分钟 (p = .012)。马尔可夫链模型证实了这些发现。匹兹堡睡眠质量指数评估的睡眠质量指标没有差异。对计划进行体外循环择期重大心脏手术的住院老年患者在手术前一天晚上获得的睡眠多导睡眠图测量结果表明，较长的睡眠时间与术后谵妄之间存在关联。
Hospitalized older patients who undergo elective cardiac surgery with cardiopulmonary bypass are prone to postoperative delirium. Self-reported shorter sleep and longer sleep have been associated with impaired cognition. Few data exist to guide us on whether shorter or longer sleep is associated with postoperative delirium in this hospitalized cohort. This was a prospective, single-site, observational study of hospitalized patients (>60 years) scheduled to undergo elective major cardiac surgery with cardiopulmonary bypass (n = 16). We collected and analysed overnight polysomnography data using the Somté PSG device and assessed for delirium twice a day until postoperative day 3 using the long version of the confusion assessment method and a structured chart review. We also assessed subjective sleep quality using the Pittsburg Sleep Quality Index. The delirium median preoperative hospital stay of 9 [Q1, Q3: 7, 11] days was similar to the non-delirium preoperative hospital stay of 7 [4, 9] days (p = .154). The incidence of delirium was 45.5% (10/22) in the entire study cohort and 50% (8/16) in the final cohort with clean polysomnography data. The preoperative delirium median total sleep time of 323.8 [Q1, Q3: 280.3, 382.1] min was longer than the non-delirium median total sleep time of 254.3 [210.9, 278.1] min (p = .046). This was accounted for by a longer delirium median non-rapid eye movement (REM) stage 2 sleep duration of 282.3 [229.8, 328.8] min compared to the non-delirium median non-REM stage 2 sleep duration of 202.5 [174.4, 208.9] min (p = .012). Markov chain modelling confirmed these findings. There were no differences in measures of sleep quality assessed by the Pittsburg Sleep Quality Index. Polysomnography measures of sleep obtained the night preceding surgery in hospitalized older patients scheduled for elective major cardiac surgery with cardiopulmonary bypass are suggestive of an association between longer sleep duration and postoperative delirium.
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影响因子：
3.3
作者：
Johnson DA;Billings ME;Hale L
通讯作者：
Hale L
神经振荡表明全身麻醉和镇静状态在神经生理学上与睡眠不同。
影响因子：
5.7
作者：
Akeju O;Brown EN
通讯作者：
Brown EN
影响因子：
24.8
作者：
Irwin MR
通讯作者：
Irwin MR
DOI：
10.1126/science.abb8739
发表时间：
2020-10-02
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Nedergaard M;Goldman SA
通讯作者：
Goldman SA
影响因子：
8.8
作者：
Flink BJ;Rivelli SK;Cox EA;White WD;Falcone G;Vail TP;Young CC;Bolognesi MP;Krystal AD;Trzepacz PT;Moon RE;Kwatra MM
通讯作者：
Kwatra MM