Sleep behavior after reverse shoulder replacement in comparison to a healthy control group : An exploratory cross-sectional study

Abstract

Individuals with shoulder pathologies frequently report sleep problems. Improving sleep quality is atreatment focus of shoulder arthroplasty. So far, it is unclear whether altered anatomy and biomechanics in reversed total shoulder arthroplasty affect sleep quality in the long term. In addition to asubjective evaluation, areliable assessment can be obtained by recording objective sleep parameters. With the help of actigraphy, body movements are registered and divided into active and inactive phases by means of threshold values. Thanks to the valid correspondence with waking and sleeping phases, the calculation of objective sleep parameters is successful. The aims of the study were to investigate whether objective sleep parameters differ in persons with reversed total shoulder arthroplasty (RTSA) 1 year postoperatively compared to ahealthy control group and to explore what the reasons are. The present work is an exploratory cross-sectional study with one measurement time point. 29study participants (15 in the RTSA-group, 14in the control group) collected objective sleep parameters and body position data during seven nights using actigraphy. The Mann-Whitney-U test was used for the mean comparison of sleep parameters. In addition, reasons for wakefulness were explored. The groups showed no significant differences in all objective sleep parameters with nearly identical sleep efficiency (p = 0.978). In the RTSA-group, 11% lay on the operated side and 65% on the back. This is just above the significance level compared to the control group with 45% in the supine position (p = 0.056). The increased use of the supine position could promote sleep-related medical conditions such as sleep apnoea and requires further research.