Sleep Quality During and After Cardiothoracic Intensive Care and Psychological Health During Recovery.

Abstract

Intensive care patients experience poor sleep quality. Psychological distress and diminished health-related quality of life (HRQOL) are also common among former intensive care unit (ICU) patients. Coronary artery bypass graft (CABG) surgery is a frequent reason adults require treatment in ICU. The effect of on- versus off-pump surgery on sleep and recovery has not been reported. The aim of this study was to assess sleep quality of CABG patients during and after ICU, psychological well-being, HRQOL during recovery, and whether on- versus off-pump surgery affects sleep and recovery. Data were collected in the ICU and hospital ward, and 2 and 6 months after hospital discharge using validated self-report questionnaires. The sample (n = 101) had a mean age of 66.6 ± 11.1 years, was 79% male, and had a median ICU stay of 2 (2-4) days and a mean body mass index of 27.3 ± 4.3; 75% underwent on-pump surgery. Poor sleep was reported by 62% of the patients at 6 months and by 12% of the patients at all time points. Off-pump CABG patients had fewer posttraumatic stress symptoms (P = .02) and better physical HRQOL (P = .01). In multivariate analysis, prehospital insomnia (P = .004), and physical (P < .0005) and mental (P < .0005) HRQOL were independently associated with sleep quality at 6 months. There was no association between on- versus off-pump CABG and sleep quality at 6 months. Sleep quality of postoperative CABG patients was poor in the ICU and hospital ward and up to 6 months after discharge from the hospital. Poor sleep quality at 6 months was associated with prehospital insomnia, and physical and mental HRQOL at 6 months, but not with on- versus off-pump surgery.