Yuchen Dai, Kaikai Shi, Qingren Liu, Changli Shen, Xinjian Lu, Xiaodong Qiu, Jie Sun
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On the first day, there were no significant differences in intraoperative sleep spindle characteristics between PSD and non-postoperative sleep disturbance (non-PSD) patients. However, by the third day, PSD patients showed lower sigma power compared to non-PSD patients, as well as lower spindle density in the bilateral frontopolar (Fp1/Fp2) and bilateral temporal (F7/F8) channels, with shorter average spindle duration (<i>P</i> < 0.05). Multivariate logistic regression analysis suggested that the average spindle density in F7/F8 channels (OR 0.543, 95% CI 0.375-0.786; <i>P</i> = 0.001) was an independent risk factor for PSD on POD 3. Furthermore, Mini-Mental State Examination (MMSE) could independently predict PSD on POD 1 (OR 0.806, 95% CI 0.656-0.991; <i>P</i> = 0.041) and POD 3 (OR 0.701, 95% CI 0.562-0.875; <i>P</i> = 0.002). Pain on movement and at rest were independently associated with PSD on POD 1 (OR 1.480, 95% CI 1.200-1.824; <i>P</i> < 0.001) and POD 3 (OR 1.848, 95% CI 1.166-2.927; <i>P</i> = 0.009), respectively.</p><p><strong>Conclusion: </strong>Intraoperative mean spindle density in the F7/F8 channels was an independent risk factor for PSD on POD 3 in elderly patients undergoing orthopedic surgery. 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We used the Athens Insomnia Scale to assess sleep quality on postoperative day (POD) 1 and POD 3 and analyzed the correlation between intraoperative sleep spindle activity and PSD through logistic regression.</p><p><strong>Results: </strong>The incidence of PSD was 65.6% on POD 1 and 41.9% on POD 3. On the first day, there were no significant differences in intraoperative sleep spindle characteristics between PSD and non-postoperative sleep disturbance (non-PSD) patients. However, by the third day, PSD patients showed lower sigma power compared to non-PSD patients, as well as lower spindle density in the bilateral frontopolar (Fp1/Fp2) and bilateral temporal (F7/F8) channels, with shorter average spindle duration (<i>P</i> < 0.05). Multivariate logistic regression analysis suggested that the average spindle density in F7/F8 channels (OR 0.543, 95% CI 0.375-0.786; <i>P</i> = 0.001) was an independent risk factor for PSD on POD 3. Furthermore, Mini-Mental State Examination (MMSE) could independently predict PSD on POD 1 (OR 0.806, 95% CI 0.656-0.991; <i>P</i> = 0.041) and POD 3 (OR 0.701, 95% CI 0.562-0.875; <i>P</i> = 0.002). Pain on movement and at rest were independently associated with PSD on POD 1 (OR 1.480, 95% CI 1.200-1.824; <i>P</i> < 0.001) and POD 3 (OR 1.848, 95% CI 1.166-2.927; <i>P</i> = 0.009), respectively.</p><p><strong>Conclusion: </strong>Intraoperative mean spindle density in the F7/F8 channels was an independent risk factor for PSD on POD 3 in elderly patients undergoing orthopedic surgery. 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引用次数: 0
摘要
目的：探讨老年骨科手术患者术中睡眠纺锤体活动与术后睡眠障碍（PSD）的关系。患者和方法：在这项前瞻性观察队列研究中，我们收集了2023年5月至2023年12月接受骨科手术的212例老年患者的术中脑电图（EEG）数据。采用雅典失眠症量表（Athens Insomnia Scale）评估术后1、3天睡眠质量（POD），并通过logistic回归分析术中睡眠纺锤体活动与PSD的相关性。结果：甲亢1期PSD发生率为65.6%，甲亢3期为41.9%。在第一天，PSD患者术中睡眠纺锤体特征与非术后睡眠障碍（non-PSD）患者无显著差异。然而，到第3天，PSD患者的sigma功率低于非PSD患者，双侧额极通道（Fp1/Fp2）和双侧颞叶通道（F7/F8）的纺锤波密度较低，平均纺锤波持续时间较短（P < 0.05）。多因素logistic回归分析表明，F7/F8通道的平均纺锤体密度(OR 0.543, 95% CI 0.375-0.786；P = 0.001)是POD 3患者PSD的独立危险因素。此外，简易精神状态检查（MMSE）可以独立预测POD 1患者的PSD (OR 0.806, 95% CI 0.656-0.991；P = 0.041)和POD 3 (OR 0.701, 95% CI 0.562-0.875；P = 0.002)。运动和休息时疼痛与POD 1的PSD独立相关(OR 1.480, 95% CI 1.200-1.824；P < 0.001)和POD 3 (OR 1.848, 95% CI 1.166-2.927；P = 0.009)。结论：术中F7/F8通道平均纺锤体密度是老年骨科手术患者POD 3上PSD的独立危险因素。MMSE和术后疼痛也单独增加PSD的风险。
Intraoperative Sleep Spindle Activity and Postoperative Sleep Disturbance in Elderly Patients Undergoing Orthopedic Surgery: A Prospective Cohort Study.
Purpose: This study aimed to investigate the relationship between intraoperative sleep spindle activity and postoperative sleep disturbance (PSD) in elderly orthopedic surgery patients.
Patients and methods: In this prospective observational cohort study, we collected intraoperative electroencephalography (EEG) data from 212 elderly patients undergoing orthopedic surgery from May 2023 to December 2023. We used the Athens Insomnia Scale to assess sleep quality on postoperative day (POD) 1 and POD 3 and analyzed the correlation between intraoperative sleep spindle activity and PSD through logistic regression.
Results: The incidence of PSD was 65.6% on POD 1 and 41.9% on POD 3. On the first day, there were no significant differences in intraoperative sleep spindle characteristics between PSD and non-postoperative sleep disturbance (non-PSD) patients. However, by the third day, PSD patients showed lower sigma power compared to non-PSD patients, as well as lower spindle density in the bilateral frontopolar (Fp1/Fp2) and bilateral temporal (F7/F8) channels, with shorter average spindle duration (P < 0.05). Multivariate logistic regression analysis suggested that the average spindle density in F7/F8 channels (OR 0.543, 95% CI 0.375-0.786; P = 0.001) was an independent risk factor for PSD on POD 3. Furthermore, Mini-Mental State Examination (MMSE) could independently predict PSD on POD 1 (OR 0.806, 95% CI 0.656-0.991; P = 0.041) and POD 3 (OR 0.701, 95% CI 0.562-0.875; P = 0.002). Pain on movement and at rest were independently associated with PSD on POD 1 (OR 1.480, 95% CI 1.200-1.824; P < 0.001) and POD 3 (OR 1.848, 95% CI 1.166-2.927; P = 0.009), respectively.
Conclusion: Intraoperative mean spindle density in the F7/F8 channels was an independent risk factor for PSD on POD 3 in elderly patients undergoing orthopedic surgery. MMSE and postoperative pain also independently increased the risk of PSD.
期刊介绍：
Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep.
Specific topics covered in the journal include:
The functions of sleep in humans and other animals
Physiological and neurophysiological changes with sleep
The genetics of sleep and sleep differences
The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness
Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness
Sleep changes with development and with age
Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause)
The science and nature of dreams
Sleep disorders
Impact of sleep and sleep disorders on health, daytime function and quality of life
Sleep problems secondary to clinical disorders
Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health)
The microbiome and sleep
Chronotherapy
Impact of circadian rhythms on sleep, physiology, cognition and health
Mechanisms controlling circadian rhythms, centrally and peripherally
Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health
Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption
Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms
Epigenetic markers of sleep or circadian disruption.
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