Journal Article•
Sleep disturbances post coronary artery bypass surgery.
TL;DR: Sleep disturbances during the first month post CABG were reported to be the result of incisional pain, difficulty finding a comfortable position and nocturia, and although less frequent over time, these problems persisted for six months.
Abstract: The purpose of this study was to describe the nature and frequency of sleep pattern disturbances in patients post coronary artery bypass (CABG) surgery. An exploratory design using telephone interviews at one week, one month, three months and six months was used to describe the incidence and nature of sleep disturbances post CABG surgery. Forty-nine patients completed all four measurement times. More than half of the patients reported sleep disturbances at each measurement time. Sleep disturbances during the first month post CABG were reported to be the result of incisional pain, difficulty finding a comfortable position and nocturia. Although less frequent over time, these problems persisted for six months. The authors propose nursing interventions to improve sleep post CABG surgery. Implications for continuing research are discussed.
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TL;DR: In this thesis sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting (CABG) at the University Hospital in Linkoping were evaluated.
Abstract: In this thesis sleep, psychological symptoms and quality of life (Qol) in patients undergoing coronary artery bypass grafting (CABG) at the University Hospital in Linkoping were evaluated. Intervie ...
19 citations
Cites background from "Sleep disturbances post coronary ar..."
...…week, including factors such as incomplete relief of pain (Simpson et al 1996, Moore 1994, King & Parrinello 1988, Soehren 1995) and nocturia (King & Parrinello 1988, Tack & Gillis 1990) and difficulties lying comfortably (Johns et al 1974, Simpson, et al 1996, Schaefer et al 1996, Moore 1994 )....
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...Schaefer et al 1996, Moore 1994, Ellis & Dudley 1976)....
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...Two fifths of the patients have reported insomnia prior to MI (Carney et al 1990) as have 27 % to 66 % of patients about to undergo heart surgery (Simpson & Lee 1996, Magni et al 1987, Simpson, et al 1996, Moore 1994, Redeker 1993, King & Parrinello 1988, Schaefer et al 1996)....
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...Other studies indicate that a daytime nap improve the health (Asplund 1994, Asplund & Åberg 1998, Trichopoulos et al 1987, Moldofsky 1994, Davidson et al 1991) and reduce the degree of fatigue after CABG (King & Parrinello 1988, Knapp-Spooner & Yarcheski 1992, Schaefer et al 1996)....
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...This is partly due to a fragmented sleep (Asplund 1994, 1996, van Diest & Appels 1994, Schaefer et al 1996, Simpson et al 1996, Moore 1994, King & Parrinello 1988, Knapp-Spooner & Yarcheski 1992, Tack & Gillis 1990)....
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TL;DR: A two-stage approach to screening is recommended, where patients are initially evaluated for the probability of having obstructive sleep apnoea using a brief questionnaire and then followed up with objective evaluation (portable home monitor or polysomnography) where necessary.
Abstract: Obstructive sleep apnoea is highly prevalent in acute coronary syndrome patients eligible for enrolment in cardiac rehabilitation programmes. This condition is an independent predictor of increased morbidity and comorbid conditions in the general population and can lead to an increase in major adverse cardiac events such as revascularization, heart failure and hospital readmission in cardiac patients. There is convincing evidence that treatments such as continuous positive airway pressure or mandibular advancement devices can successfully treat obstructive sleep apnoea and these conditions can be improved or negated resulting in improved cardiac rehabilitation outcomes and improved health related quality of life. Given the potential benefits of obstructive sleep apnoea treatment it would make sense to screen for this condition upon entry to out-patient cardiac rehabilitation programmes. A two-stage approach to screening is recommended, where patients are initially evaluated for the probability of having obstructive sleep apnoea using a brief questionnaire (The STOP-Bang) and then followed up with objective evaluation (portable home monitor or polysomnography) where necessary. Potential barriers to further referral and treatment could be partly mitigated by the training of cardiac rehabilitation staff in sleep disorders and screening.
17 citations
TL;DR: How sleep and activity patterns vary during and after hospitalization in a small population of older, predominately African American general medicine patients is described to improve patient recovery from illness.
Abstract: STUDY OBJECTIVES Although sleep disturbance is common in acutely ill patients during and after a hospitalization, how hospitalization affects sleep in general medicine patients has not been well characterized. We describe how sleep and activity patterns vary during and after hospitalization in a small population of older, predominately African American general medicine patients. METHODS Patients wore a wrist accelerometer during hospitalization and post-discharge to provide objective measurements of sleep duration, efficiency, and physical activity. Random effects linear regression models clustered by subject were used to test associations between sleep and activity parameters across study days from hospitalization through post-discharge. RESULTS We recorded 404 nights and 384 days from 54 patients. Neither nighttime sleep duration nor sleep efficiency increased from hospitalization through post-discharge (320.2 vs. 320.2 min, p = 0.99; 74.0% vs. 71.7%, p = 0.24). Daytime sleep duration also showed no significant change (26.3 vs. 25.8 min/day, p = 0.5). Daytime physical activity was significantly less in-hospital compared to post-discharge (128.6 vs. 173.2 counts/min, p < 0.01) and increased 23.3 counts/min (95% CI = 16.5 to 30.6, p < 0.01) per hospital day. A study day and post-discharge period interaction was observed demonstrating slowed recovery of activity post-discharge (β 3 = -20.8, 95% CI = -28.8 to -12.8, p < 0.01). CONCLUSIONS Nighttime sleep duration and efficiency and daytime sleep duration were similar in-hospital and post-discharge. Daytime physical activity, however, was greater post-discharge and increased more rapidly during hospitalization than post-discharge. Interventions, both in hospital and at home, to restore patient sleep and sustain activity improvements may improve patient recovery from illness.
17 citations
TL;DR: The focus of this article is to identify what specific nursing-sensitive outcomes have been measured or monitored on cardiac surgery patients in the past and then suggest potential next generation outcomes.
Abstract: Achieving optimum patient outcomes has always been the primary focus of healthcare providers. The degree to which any healthcare discipline can impact outcomes varies since patient outcomes are multiple and diverse. As the measurement and reporting of outcomes has moved into the arena of public reporting, it has become essential for disciplines to be able to identify which outcomes they can either partially or completely influence. The focus of this article is to (1) identify what specific nursing-sensitive outcomes have been measured or monitored on cardiac surgery patients in the past and then (2) suggest potential next generation outcomes.
12 citations
TL;DR: The cause of sleeplessness after CABG surgery may be the temporary deterioration of circulation in the centers of the brain stem and hypothalamus, which control sleep and awakening.
Abstract: Background. The purpose of this study was to investigate changes in sleep characteristics by examining both subjective tests and objective parameters such as actigraphic sleep analysis in patients who underwent coronary artery bypass graft surgery (CABG). Patients and Methods. Forty-five patients who underwent CABG operations and did not have any sleep disturbance were examined. They were evaluated by subjective and objective sleep parameters at the beginning of the examination and on the fifth postoperative day. Forty healthy subjects who did not undergo the operation were also evaluated. Results. The Pittsburgh Index and Epworth values in the postoperative group were significantly higher, but Maintenance of Wakefulness Test lengths were significantly shorter than in the preoperative and control groups. Sleep latency, napping episodes, total napping periods, and fragmentation index values of the postoperative group were significantly higher, but sleep efficiency values were significantly lower than in the preoperative and control groups. Conclusion. The cause of sleeplessness after CABG surgery may be the temporary deterioration of circulation in the centers of the brain stem and hypothalamus, which control sleep and awakening. It can be proposed that the improvement of the circulation in these centers a couple of months after the operation help to regain sleep control, and thus sleep disturbances disappear.
9 citations