Gumina S, Candela V, Passaretti D, Venditto T, Mariani L, Giannicola G
Department of Orthopaedics and Traumatology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy.
Musculoskelet Surg. 2016 Dec;100(Suppl 1):33-38. doi: 10.1007/s12306-016-0405-4. Epub 2016 Nov 30.
The literature is unanimous in saying that shoulder pain, due to rotator cuff tear (RCT), may be mostly at night; to our knowledge, this statement is not supported by scientific evidence. Our aim was to investigate sleep quality and disturbances in patient with RCT and in a control group.
A case-control design study was used. We enrolled 324 consecutive patients (Group A) (156M-168F, mean age ± SD: 64.94 ± 6.97; range 47-74) who underwent arthroscopic rotator cuff repair. Tear size was determined intraoperatively. The control group (Group B) included 184 subjects (80M-104F, mean age ± SD = 63.34 ± 6.26; range 44-75) with no RCT. All participants were submitted to two standardized self-reported questionnaires evaluating sleep quality and disturbances: the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Data were submitted to statistics.
We found no significant differences between the two groups according to both PSQI (Group A: 5.22 ± 2.59; Group B: 5.21 ± 2.39) and ESS (Group A: 2.59 ± 2.54; Group B: 5.76 ± 2.63), p > 0.05. Patients with small tears had average PSQI and ESS higher than patients with large and massive lesions (p < 0.005). Pearson's test showed that tear severity was negatively correlated with both sleep latency (r = -0.35, β = 0.069, p < 0.005) and sleep disturbances (r = -0.65, β = 0.053, p < 0.001).
RCT is only one of the responsible causes for sleep disturbance in middle-aged and elderly subjects. Patients with small tears have a poorer sleep quality with respect to those with a more severe tear; particularly, they not only take more time to fall asleep, but also have a more disturbed sleep compared to patients with large and massive tears.
III.
文献一致认为，由于肩袖撕裂（RCT）导致的肩部疼痛可能主要出现在夜间；据我们所知，这一说法并无科学依据。我们的目的是调查肩袖撕裂患者和对照组的睡眠质量及睡眠障碍情况。
采用病例对照设计研究。我们纳入了324例连续接受关节镜下肩袖修复术的患者（A组）（男性156例 - 女性168例，平均年龄±标准差：64.94±6.97；范围47 - 74岁）。术中确定撕裂大小。对照组（B组）包括184名无肩袖撕裂的受试者（男性80例 - 女性104例，平均年龄±标准差 = 63.34±6.26；范围44 - 75岁）。所有参与者均接受两份标准化的自我报告问卷，以评估睡眠质量和睡眠障碍：匹兹堡睡眠质量指数（PSQI）和爱泼华嗜睡量表（ESS）。数据进行统计学分析。
根据PSQI（A组：5.22±2.59；B组：5.21±2.39）和ESS（A组：2.59±2.54；B组：5.76±2.63），两组之间均未发现显著差异，p>0.05。小撕裂患者的PSQI和ESS平均值高于大撕裂和巨大撕裂患者（p<0.005）。Pearson检验表明，撕裂严重程度与睡眠潜伏期（r = -0.35，β = 0.069，p<0.005）和睡眠障碍（r = -0.65，β = 0.053，p<0.001）均呈负相关。
肩袖撕裂只是中老年人群睡眠障碍的原因之一。小撕裂患者的睡眠质量比严重撕裂患者更差；特别是，与大撕裂和巨大撕裂患者相比，他们不仅入睡时间更长，而且睡眠更易受干扰。
III级
