Assessing sleep quality in gynecologic oncology patients after surgery

Abstract

<h3>Objectives:</h3> High quality sleep is important for maintaining immune function, wound healing, and physical and emotional well-being. Our objective was to determine the quality of sleep in women admitted for post-operative recovery after surgical management for a suspected gynecologic malignancy. <h3>Methods:</h3> We surveyed women who were admitted to the hospital for at least one midnight after undergoing a surgical procedure for a suspected gynecologic malignancy between September 2020 and October 2020. The Pittsburgh Sleep Quality Index (19 item self-report questionnaire) was used to assess baseline sleep quality in the month prior to the planned procedure. The Richards-Campbell Sleep Questionnaire (5 item self-report survey) was used to assess nightly sleep quality during the subject's hospitalization. A chart review was also completed to assess for patient or surgical factors associated with poor sleep. <h3>Results:</h3> Twenty-three patients met the study criteria, of which 20 (87%) agreed to participate. The mean age was 58 (SD = 15), the mean BMI was 32.2 (SD = 8.3). Eighty percent of patients underwent surgery for confirmed malignancy, with uterine cancer (30%) and ovarian cancer (25) comprising the majority of diagnoses. The median admission length was 2 days interquartile range (IQR = 1-4.5), fifty percent of patients underwent an open procedure. Based on Pittsburgh Sleep Quality Index (PSQI) results, 15 patients (75%) reported poor sleep quality in the month prior to their surgery. The total RCSQ score was the worst on the first post-operative day (38.3, SD=28.3). Sleep quality improved on post-operative day 2 (67.3, SD=12.2), but then declined over the remainder of the hospitalization. <h3>Conclusions:</h3> Sleep quality is poor in women hospitalized after surgery with gynecologic oncologists. Sleep is an under recognized factor in optimizing postoperative recovery. The high prevalence of poor sleep during hospital-based post-operative recovery among gynecologic oncology patients warrants the development of evidence-based interventions for improving sleep and sleep quality.