267 Perioperative sleep study in geriatric cardiac surgical patients using wireless wearable devices

Abstract

Abstract Introduction Sleep is a fundamental necessity for health and is commonly disrupted in the perioperative period. Technological improvements leveraging dry electroencephalographic (EEG) sensors have opened the door for large-scale quantitative assessments of sleep in relation to perioperative outcomes. Methods Patients utilized the Dreem (Rhythm, New York USA), a wireless EEG headband, to acquire their own preoperative nocturnal sleep records at home. Following cardiac surgery, postoperative recordings were obtained with staff assistance until postoperative night 7. Sleep records were scored as rapid eye movement (REM) and non-rapid eye movement (NREM) stages N1-N3, using modified American Academy of Sleep Medicine guidelines. Results Of 100 patients enrolled for perioperative sleep recordings, 74 patients provided 132 preoperative records; 80% were scorable with a median total sleep time (TST) of 209.8 minutes. TST was distributed as 8.3% N1, 70.6% N2, 2.1% N3 and 19% REM, consistent with expected sleep structure in geriatric populations. EEG markers for staging sleep were evaluated in the scorable records: 92% with sleep spindles, 98% with K-complexes, 69% with slow waves, 92% with sawtooth waves, and 80% with rapid eye movements. Among 26 patients with multiple preoperative sleep recordings, no significant within-subject differences in sleep structure were observed (all p > 0.05, paired Wilcoxon sign-rank test). 270 postoperative nocturnal sleep recordings were obtained from 83 patients, 70% of which were scorable. TST in scorable postoperative records was distributed as 14.9% N1, 78.6% N2, 0.9% N3 and 5.6% REM. Durations of REM and N3 sleep were significantly reduced in postoperative (POD 1-4) overnight recordings compared to preoperative measurements (Skillings–Mack test, p < 0.001 and p = 0.02 for REM and N3, respectively). Conclusion Wireless EEG devices enhance the feasibility of assaying perioperative sleep. A single night of unattended, ambulatory sleep monitoring is sufficient to establish a preoperative baseline. Multiple preoperative and postoperative sleep studies were tolerated by patients, which showed reductions of N3 and REM sleep in the early postoperative period. This study demonstrates the feasibility of using the Dreem for monitoring sleep macro- and microstructural EEG elements in the perioperative setting. Support (if any):