Predictive factors of postoperative sleep disturbance after total hip arthroplasty: a retrospective observational study of 759 patients.

Abstract

Postoperative sleep disturbance (PSD) is a common yet easily overlooked complication that affects early postoperative recovery. The purpose of this study was to identify the predictive factors of PSD. Retrospective cross-sectional study. The First Affiliated Hospital of Chongqing Medical University. 759 patients undergoing primary unilateral total hip arthroplasty. PSD was measured using the Numeric Rating Scale score of 1-10 or the Pittsburgh Sleep Quality Index. 759 patients were included in the analysis. The incidence of PSD on postoperative day (POD) 1, POD 7 and POD 30 was 55.3%, 19.6% and 14.6%. Predictive factors included preoperative Visual Analogue Scale (VAS) (OR, 1.201 (95% CI, 1.054 to 1.369), p=0.006), satisfaction with ward environment (OR, 0.816 (95% CI, 0.711 to 0.936), p=0.004), dexmedetomidine (OR, 0.493 (95% CI, 0.263 to 0.925), p=0.028) and VAS on POD 1 (OR, 1.203 (95% CI, 1.052 to 1.382), p=0.008). VAS on POD 7 was associated with PSD on POD 7 (OR, 1.360 (95% CI, 1.103 to 1.678), p=0.004). VAS on POD 30 was associated with PSD on POD 30 (OR, 1.236 (95% CI, 1.021 to 1.495), p=0.029). Patients who experience preoperative pain, low satisfaction with ward environment, absence of intraoperative dexmedetomidine use and postoperative pain are at high risk of PSD on POD 1 after total hip arthroplasty. Postoperative pain was associated with PSD on POD 7 and 30. Chinese Clinical Trial Registry (ChiCTR2300078231).