Yilmaz Hikmet, Iskesen Ihsan
Department of Neurology, Celal Bayar University School of Medicine, Manisa, Turkey.
Heart Surg Forum. 2007;10(1):E16-20. doi: 10.1532/HSF98.20061128.
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).
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.
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.
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.
本研究的目的是通过对接受冠状动脉旁路移植术(CABG)的患者进行主观测试和客观参数(如活动记录仪睡眠分析)来研究睡眠特征的变化。
对45例接受CABG手术且无任何睡眠障碍的患者进行检查。在检查开始时和术后第5天通过主观和客观睡眠参数对他们进行评估。还对40例未接受手术的健康受试者进行了评估。
术后组的匹兹堡指数和爱泼华值显著更高,但清醒维持测试时长显著短于术前组和对照组。术后组的睡眠潜伏期、小睡次数、总小睡时长和碎片化指数值显著更高,但睡眠效率值显著低于术前组和对照组。
CABG手术后失眠的原因可能是控制睡眠和觉醒的脑干和下丘脑中心的循环暂时恶化。可以提出,术后几个月这些中心循环的改善有助于恢复睡眠控制,从而睡眠障碍消失。