School of Nursing, Chun Shan Medical University; Research Consultant, Department of Nursing, Chun Shan Medical University Hospital.
J Nurs Res. 2011 Dec;19(4):275-88. doi: 10.1097/JNR.0b013e318236cf68.
Sleep is a vital and restorative human function. However, it has been reported that up to 50% of heart surgery patients experience sleep disturbance during hospitalization and after discharge.
This study describes sleep patterns in adults over the recovery course after heart surgery and works to identify potential interventions. Researchers analyzed and synthesized studies of sleep patterns and sleep-related factors in heart surgery patients.
Observational studies describing sleep through the course of recovery from heart surgery were searched from databases of PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Current Contents, and Chinese Electronic Periodicals Service from 1966 to 2011. Only studies that used polysomnography, actigraphy, or self-report sleep questionnaires to measure sleep were recruited in this review. Results of sleep patterns and sleep quality were pooled from homogeneity studies.
Eight studies that investigated sleep patterns in heart surgery patient and nine studies that examined factors associated with sleep disturbances in this patient group were analyzed and synthesized. Serious problems including low sleep efficiency and difficulty in maintaining sleep often happened during the first postoperative week. It took 2 months for sleep to recover to preoperational levels. Although sleep quality improved over time, sleep disturbances still persisted through 6 months of recovery. Physical factors, including pain, dyspnea, nocturia, and cardiac function, and environmental factors, including noise, light, and procedures on patients, were associated with sleep disturbances during hospitalization. Psychological factors, including anxiety and depression, affected sleep during the first -6 months after discharge. Individual factors of age and gender affected sleep through the entire recovery course. CONCLUSIONS/IMPLICATION FOR PRACTICE: Sleep disturbances persist over the course of recovery in heart surgery patients, and sleep disturbance is associated with individual, physiological, psychological, and environmental factors. Findings suggest that management of major symptoms and control of the patient's sleeping environment during hospitalization and at early recovery stage as well as mental healthcare after discharge may improve sleep quality and recovery in heart surgery patients.
睡眠是人类重要的恢复性生理功能。然而，据报道，多达 50%的心脏手术患者在住院期间和出院后会出现睡眠障碍。
本研究描述了心脏手术后成年人在恢复过程中的睡眠模式，并致力于确定潜在的干预措施。研究人员分析和综合了心脏手术患者睡眠模式和与睡眠相关因素的研究。
从 1966 年至 2011 年，在 PubMed、MEDLINE、护理与联合健康文献累积索引、当前内容和中国电子期刊服务数据库中搜索描述心脏手术后恢复过程中睡眠的观察性研究。只有使用多导睡眠图、活动记录仪或自我报告睡眠问卷来测量睡眠的研究才被纳入本综述。来自同质性研究的睡眠模式和睡眠质量结果被汇总。
分析和综合了 8 项研究心脏手术患者睡眠模式和 9 项研究该患者群体睡眠障碍相关因素的研究。严重的问题，包括睡眠效率低和难以维持睡眠，经常发生在术后第一周。睡眠需要 2 个月才能恢复到术前水平。尽管睡眠质量随着时间的推移而改善，但在恢复的 6 个月内仍存在睡眠障碍。身体因素，包括疼痛、呼吸困难、夜尿和心脏功能，以及环境因素，包括噪音、光线和对患者的操作，与住院期间的睡眠障碍有关。心理因素，包括焦虑和抑郁，影响出院后前 6 个月的睡眠。年龄和性别等个体因素贯穿整个恢复过程影响睡眠。
结论/对实践的启示：心脏手术患者在恢复过程中持续存在睡眠障碍，睡眠障碍与个体、生理、心理和环境因素有关。研究结果表明，在住院期间和早期恢复阶段管理主要症状和控制患者的睡眠环境以及出院后的心理健康护理可能会改善心脏手术患者的睡眠质量和恢复。
