老年患者术后失眠的深入分析及其对康复的影响。

An in-depth analysis of postoperative insomnia in elderly patients and its implications on rehabilitation.

机构信息

Department of Neurology, Xuanwu Hospital, Capital Medical University, 45 Changchun St. Xicheng District, Beijing, China.

Department of Neurology, People's Hospital of Rizhao, Rizhao, China.

出版信息

Sleep Breath. 2024 Oct;28(5):2187-2195. doi: 10.1007/s11325-024-03063-8. Epub 2024 Jun 11.

DOI:10.1007/s11325-024-03063-8

PMID:38858327

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11450051/

Abstract

OBJECTIVES

(1) Assess the prevalence of postoperative insomnia; (2) identify the risk factors for postoperative insomnia before exposure to surgery; (3) explore the impact of postoperative insomnia on rehabilitation.

METHODS

A study was conducted with 132 participants aged ≥ 65 undergoing spine interbody fusion. We collected the basic demographic data, Numeric Rating Scales (NRS), Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS), and Beck Anxiety Inventory (BAI). We measured Quality of Recovery 40 (QoR-40), GDS, BAI, NRS, and PSQI on the first and third nights post-surgery, followed by QoR-40 and NRS assessments two weeks after surgery.

RESULTS

The cases of postoperative insomnia on the first and third nights and after two weeks were 81 (61.36%), 72 (54.55%), and 64 (48.48%), respectively, and the type of insomnia was not significantly different (P = 0.138). Sleep efficiency on the first night was 49.96% ± 23.51. On the first night of postoperative insomnia, 54 (66.67%) cases were depression or anxiety, and the PSQI was higher in this group than in the group without anxiety or depression (P < 0.001). PSQI, GDS, and the time of surgery were related factors for postoperative insomnia (PPSQI < 0.001, PGDS = 0.008, and PTime = 0.040). Postoperative rehabilitation showed differences between the insomnia and non-insomnia groups (P < 0.001).

CONCLUSIONS

The prevalence of postoperative insomnia in the elderly was high, and postoperative insomnia had a significant correlation with postoperative rehabilitation. Interventions that target risk factors may reduce the prevalence of postoperative insomnia and warrant further research.

CLINICAL TRIAL REGISTRATION

Multivariate analysis of postoperative insomnia in elderly patients with spinal surgery and its correlation with postoperative rehabilitation ( https://www.chictr.org.cn/bin/project/edit?pid=170201 ; #ChiCTR2200059827).

摘要

目的

（1）评估术后失眠的发生率；（2）确定术前暴露于手术前术后失眠的危险因素；（3）探讨术后失眠对康复的影响。

方法

对 132 名年龄≥65 岁行脊柱椎间融合术的患者进行了一项研究。我们收集了基本人口统计学数据、数字评分量表（NRS）、匹兹堡睡眠质量指数（PSQI）、老年抑郁量表（GDS）和贝克焦虑量表（BAI）。我们在术后第一和第三晚测量了康复质量 40 分（QoR-40）、GDS、BAI、NRS 和 PSQI，两周后进行了 QoR-40 和 NRS 评估。

结果

术后第一和第三晚及两周后发生术后失眠的病例分别为 81 例（61.36%）、72 例（54.55%）和 64 例（48.48%），失眠类型无显著差异（P=0.138）。第一晚的睡眠效率为 49.96%±23.51。术后失眠第一晚，54 例（66.67%）为抑郁或焦虑，该组 PSQI 高于无焦虑或抑郁组（P<0.001）。PSQI、GDS 和手术时间是术后失眠的相关因素（PPSQI<0.001，PGDS=0.008，PTime=0.040）。失眠组和非失眠组的术后康复存在差异（P<0.001）。