Preoperative sleep disruption and postoperative functional disability in lung surgery patients: a prospective observational study.

Abstract

Our aims were to evaluate the prevalence of preoperative acute sleep disruption in the hospital and to assess perioperative sleep quality and the effects of acute sleep disruption on postoperative functional recovery in a surgical setting. This prospective observational study included 24 patients aged ≥20years who underwent video-assisted thoracoscopic surgical lobectomy for lung cancer under general anesthesia at a tertiary hospital in Japan between October 2016 and May 2017. Actigraphy was performed for 7days in the hospital, including the night before surgery. We defined acute sleep disturbance as less than 85% preoperative sleep efficiency and analyzed its effect on postoperative functional disability using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and Mann-Whitney U testing. The perioperative change in sleep efficiency was compared using a Dunn analysis. A high score on the WHODAS 2.0 is indicative of impaired function. Nineteen (79.1%) patients had low sleep efficiency in the hospital prior to surgery. Three months after surgery, the 12-item WHODAS 2.0 score was higher in patients with acute sleep disturbance than in those without it (38.8 versus 33.3, p = 0.02, effect size 0.5). Sleep efficiency decreased significantly on the 5th postoperative day in patients with acute sleep disturbance. Our results showed a high prevalence of acute sleep disturbance. Patients with acute sleep disruption had low postoperative sleep efficiency and impaired functional ability three months after surgery.