Abstract
Background Total knee arthroplasty (TKA) patients are frequently subjected to immediate postsurgical pain and sleep disruption. Recent studies have explored postoperative sleep disruption using subjective assessments, however the literature on objective sleep quality markers remains sparse. Purpose The aim of this pilot study was to assess objective sleep quality measures in the immediate postoperative period following TKA. Design/Methods Patients undergoing primary TKA at a level two medical center were enrolled in a prospective study. Wearable sleep tracking devices (WHOOP, USA) were used to record resting heart rate (RHR), heart rate variability (HRV), hours of sleep, number of sleep disturbances per hour, hours of deep sleep (N3), hours of rapid eye movement (REM) sleep, and restorative sleep (deep and REM sleep combined) for at least a week preoperatively and four weeks postoperatively. The mean preoperative baseline values were compared to mean values over the first four postoperative weeks. Results Out of 25 enrolled patients, eight patients with complete data were included for analysis,. The mean hours of deep sleep (0.7 vs. 1.1; p=0.043) and restorative sleep (1.7 vs 2.3; p=0.043) were decreased in the first postoperative week compared to the fourth postoperative week. There were no other significant differences regarding any other outcomes. Conclusion This pilot study suggests that TKA patients have disruptions in deep and restorative sleep in the immediate postoperative period, although the sample size was limited by patient compliance with the wearable devices. Further study with greater sample size is warranted to further explore trends in postoperative sleep quality.
Published Version
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