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Circadian distribution of sleep phases after major abdominal surgery

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TLDR
Patients have significantly increased REM sleep, LS, and reduced time awake during the daytime period after surgery compared with before surgery, suggesting disturbances in the circadian regulation of the sleep-wake cycle may be involved in the development of postoperative sleep disturbances.
Abstract
Background It is believed that the severely disturbed night-time sleep architecture after surgery is associated with increased cardiovascular morbidity with rebound of rapid eye movement (REM). The daytime sleep pattern of patients after major general surgery has not been investigated before. We decided to study the circadian distribution of sleep phases before and after surgery. Methods Eleven patients undergoing elective major abdominal surgery were included in the study. Continuous ambulatory polysomnographic monitoring was made 24 h before surgery and 36 h after surgery, thus including two nights after operation. Sleep was scored independently by two blinded observers and the recordings were reported as awake, light sleep (LS, stages I and II), slow wave sleep (SWS, stages III and IV), and REM sleep. Results There was significantly increased REM sleep ( P =0.046), LS ( P =0.020), and reduced time awake ( P =0.016) in the postoperative daytime period compared with the preoperative daytime period. Five patients had REM sleep during the daytime after surgery. Three of these patients did not have REM sleep during the preceding postoperative night. There was significantly reduced night-time REM sleep for two nights after surgery compared with before surgery ( P =0.001). Conclusions Patients have significantly increased REM sleep, LS, and reduced time awake during the daytime period after surgery compared with before surgery. Disturbances in the circadian regulation of the sleep–wake cycle may be involved in the development of postoperative sleep disturbances.

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Citations
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New insights into the pathophysiology of postoperative cognitive dysfunction

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Identification of Patients at Risk for Postoperative Respiratory Complications Using a Preoperative Obstructive Sleep Apnea Screening Tool and Postanesthesia Care Assessment

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Independent Predictors and Outcomes of Unanticipated Early Postoperative Tracheal Intubation after Nonemergent, Noncardiac Surgery

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Postoperative changes in sleep-disordered breathing and sleep architecture in patients with obstructive sleep apnea

TL;DR: Postoperatively, sleep architecture was disturbed and AHI was increased in both OSA and non-OSA patients and breathing disturbances during sleep were greatest on postoperative N3.
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Factors Associated with Postoperative Exacerbation of Sleep-disordered Breathing

TL;DR: Patients with a higher preoperative AHI were predicted to have a higher postoperatively AHI and slow wave sleep percentage was inversely associated with postoperative A HI and central apnea index.
References
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Journal ArticleDOI

Melatonin in Patients with Reduced REM Sleep Duration: Two Randomized Controlled Trials

TL;DR: The findings show that exogenous melatonin, when administered at the appropriate time, seems to normalize circadian variation in human physiology and may have a strong impact on general health, especially in the elderly and in shift workers.
Journal ArticleDOI

Nonuniform Nighttime Distribution of Acute Cardiac Events A Possible Effect of Sleep States

TL;DR: Nocturnal myocardial infarction, sudden cardiac death, and AICD discharge exhibit nonuniform distributions, consistent with the hypothesis that sleep-state dependent fluctuations in autonomic nervous system activity may trigger the onset of major cardiovascular events.
Journal Article

Postoperative mental confusion--association with postoperative hypoxemia.

J. Rosenberg, +1 more
- 01 Jul 1993 - 
TL;DR: In this article, the authors found a significant relationship between mental function on the third day after operation and mean oxygen saturation (SpO2) with a pulse oximeter on a preoperative night and on the second night after operation (11:00 PM to 7:00 AM).
Journal ArticleDOI

Variant angina associated with angiographically demonstrated coronary artery spasm and REM sleep.

TL;DR: Severe narrowing, consistent with spasm, producing nearly total occlusion of a minimally diseased segment of the right coronary artery was demonstrated by selective coronary arteriography in a patient with Prinzmetal's variant angina.
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