scholarly journals Sleep Well and Recover Faster with Less Pain—A Narrative Review on Sleep in the Perioperative Period

2021 ◽  
Vol 10 (9) ◽  
pp. 2000
Author(s):  
Reetta M. Sipilä ◽  
Eija A. Kalso
Keyword(s):  
Risk Factors ◽  
Postoperative Pain ◽  
Sleep Quality ◽  
Severe Pain ◽  
Sleep Disturbances ◽  
Perioperative Period ◽  
Narrative Review ◽  
Pharmacological Interventions ◽  
Know How ◽  
Before And After

Sleep disturbance, pain, and having a surgical procedure of some kind are all very likely to occur during the average lifespan. Postoperative pain continues to be a prevalent problem and growing evidence supports the association between pain and sleep disturbances. The bidirectional nature of sleep and pain is widely acknowledged. A decline in sleep quality adds a risk for the onset of pain and also exacerbates existing pain. The risk factors for developing insomnia and experiencing severe pain after surgery are quite similar. The main aim of this narrative review is to discuss why it is important to be aware of sleep disturbances both before and after surgery, to know how sleep disturbances should be assessed and monitored, and to understand how better sleep can be supported by both pharmacological and non-pharmacological interventions.

scholarly journals Risk factors of sleep disturbances in elderly patients after thoracic surgery: a preliminary clinical trial

2021 ◽  
Author(s):  
Bing Li ◽  
Yao Liu ◽  
Jia Jia ◽  
Fudong Tang ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Pain ◽  
Elderly Patients ◽  
Thoracic Surgery ◽  
Sleep Quality ◽  
Nerve Block ◽  
Sleep Disturbances ◽  
Chronic Insomnia ◽  
Independent Risk Factors ◽  
Surgical Duration

Abstract BackgroundTo identify the risk factors of sleep disturbances in elderly patients after thoracic surgery.MethodsWe enrolled 200 patients, all aged > 65, who underwent elective thoracic surgery and had American Society of Anesthesiology physical status II–III. We recorded general information, surgical diagnosis, type of operation, surgical duration, bleeding, nerve block, and dexmedetomidine dose given by controlled intravenous analgesia (PCIA). We used the Pittsburgh Sleep Quality Index (PSQI) at the end of PCIA to evaluate subjective sleep quality; we also recorded postoperative pain, nausea, and vomiting. We divided patients into a non-sleep disturbances group and a sleep disturbances group with PSQI \(\ge\)5 as the cutoff.ResultsA total of 76 (45%) of the patients had sleep disturbances after thoracic surgery. There were significant differences between groups in terms of chronic insomnia, hypertension, diabetes, BMI, age, surgical diagnosis, type of operation, surgical duration, bleeding, nerve block, and dexmedetomidine dose in PCIA. Logistic regression analysis revealed that chronic insomnia, BMI, diabetes, surgical diagnosis, type of operation, surgical duration, bleeding, and postoperative pain were independent risk factors of postoperative sleep disturbances. This analysis also showed that nerve block and dexmedetomidine dose in PCIA were significant protective factors of postoperative sleep disturbances.ConclusionChronic insomnia, BMI, diabetes, surgical diagnosis, type of operation, surgical duration, bleeding, and postoperative pain are independent risk factors of postoperative sleep disturbances in elderly patients. Nerve block and the dose of dexmedetomidine in PCIA are protective.Trial registrationChiCTR2000035169; retrospectively registered on 01.08.2020.

scholarly journals Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine

2021 ◽  
Author(s):  
Kneginja Richter ◽  
Stefanie Kellner ◽  
Thomas Hillemacher ◽  
Olga Golubnitschaja
Keyword(s):  
Risk Factors ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Acute Infection ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Mild Disease ◽  
Depth Analysis ◽  
Medical Approach ◽  
Poor Outcomes

AbstractSleep quality and duration play a pivotal role in maintaining physical and mental health. In turn, sleep shortage, deprivation and disorders are per evidence the risk factors and facilitators of a broad spectrum of disorders, amongst others including depression, stroke, chronic inflammation, cancers, immune defence insufficiency and individual predisposition to infection diseases with poor outcomes, for example, related to the COVID-19 pandemic. Keeping in mind that COVID-19-related global infection distribution is neither the first nor the last pandemic severely affecting societies around the globe to the costs of human lives accompanied with enormous economic burden, lessons by predictive, preventive and personalised (3P) medical approach are essential to learn and to follow being better prepared to defend against global pandemics. To this end, under extreme conditions such as the current COVID-19 pandemic, the reciprocal interrelationship between the sleep quality and individual outcomes becomes evident, namely, at the levels of disease predisposition, severe versus mild disease progression, development of disease complications, poor outcomes and related mortality for both - population and healthcare givers. The latter is the prominent example clearly demonstrating the causality of severe outcomes, when the long-lasting work overload and shift work rhythm evidently lead to the sleep shortage and/or deprivation that in turn causes immune response insufficiency and strong predisposition to the acute infection with complications. This article highlights and provides an in-depth analysis of the concerted risk factors related to the sleep disturbances under the COVID-19 pandemic followed by the evidence-based recommendations in the framework of predictive, preventive and personalised medical approach.

352 Feasibility of Hypnosis as Adjunctive Treatment for Subjective Sleep Disturbance: A Pilot Study and Proof of Concept

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A140-A141
Author(s):  
Emma Zhao ◽  
Afik Faerman ◽  
David Spiegel
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Positive Impact ◽  
Self Report ◽  
Adjunctive Treatment ◽  
Current Evidence ◽  
Data Set ◽  
Sleep Complaints ◽  
Subjective Sleep ◽  
Before And After

Abstract Introduction Hypnosis-based interventions have been shown to have a positive impact on several dimensions of sleep health. However, current evidence is limited as only a paucity of studies included populations with sleep complaints. Here we present a pilot data set to demonstrate the feasibility of developing a hypnosis-based adjunctive treatment for subjective sleep complaints. Methods Eleven adults (42% female; mean age 45±16.87 years) who sought treatment at the Stanford Sleep Medicine Center or Center for Integrative Medicine for subjective sleep complaints received hypnosis as adjunctive treatment. Self-report questionnaires were used to assess the weekly frequency of subjective sleep disturbances experienced before and after treatment, as well as 5-point Likert scale ratings of perceived qualitative improvement in symptom severity and overall sleep quality. Results Five participants (45%) reported a reduction in symptom frequency and severity after hypnosis treatment. All five participants attributed at least some of the improvement to hypnosis treatment. Most participants (63%) observed post-treatment improvements in their overall sleep quality. No participants reported adverse effects of hypnosis. Conclusion Results suggest hypnosis-based adjunctive treatment may be effective for alleviating subjective sleep disturbances. The findings serve as preliminary support for further randomly controlled trials in larger samples. Support (if any):

scholarly journals Non-pharmacological sleep interventions for pediatric cancer patients and survivors: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Peter L. Stavinoha ◽  
Ineke M. Olsthoorn ◽  
Maria C. Swartz ◽  
Sara Nowakowski ◽  
Stephanie J. Wells ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Standard Of Care ◽  
Sleep Diary ◽  
Pharmacological Interventions ◽  
Pediatric Cancer Patients

Abstract Background Sleep disturbances constitute a common complication in pediatric cancer patients and survivors and are frequently severe enough to warrant treatment. Suboptimal sleep has been associated with decreased emotional well-being and cognitive functioning and increased behavioral problems. Standardized guidelines for non-pharmacological sleep interventions for adults with cancer exist, but no standard of care intervention or standard guidelines are available to guide such intervention in pediatric cancer patients and survivors. Therefore, effective behavioral interventions for improving sleep quality need to be identified. The objective of the review is to evaluate the effect of non-pharmacological sleep interventions on sleep quality in pediatric cancer patients and survivors. Methods The review will consider studies that include children and adolescents between 0 and 18 years diagnosed with cancer or who have a history of cancer who have non-respiratory sleep disturbance. We will include experimental and quasi-experimental studies evaluating non-pharmacological interventions such as psychological interventions, technical/device interventions, interventions targeting physical activity, and complementary and alternative medicine interventions (e.g., yoga, massage, music). Interventions involving medications, ingestible supplements, products purported to work through absorption, and medical devices will be excluded. Primary outcome will be sleep quality as measured by methods including retrospective ratings, daily sleep diary, and validated questionnaires. Secondary outcomes will include total sleep time, sleep onset latency, wake after sleep onset, daytime sleepiness, and daytime sleep duration (naps) as measured by retrospective ratings, daily sleep diary, validated questionnaires, and/or actigraphy. Databases will include MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, CINAHL (Ebsco), and PsycINFO (Ovid) and will be queried from database inception to present. Two reviewers will independently screen all citations, full-text articles, and extract data. The study methodological quality will be assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Data will be extracted and findings pooled and synthesized using a meta-aggregation approach via the JBI System for the Unified Management, Assessment, and Review of Information (SUMARI). If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., methodological quality, study design, outcome measures). Discussion This systematic review will synthesize and consolidate evidence on existing non-pharmacological interventions to improve sleep in pediatric cancer patients and survivors. Findings may help inform practitioners working with pediatric cancer patients and survivors experiencing sleep disturbances and is intended to identify gaps and opportunities to improve methodical quality of further non-pharmacological sleep intervention research in this population toward developing an eventual standard of care. Systematic review registration PROSPERO CRD42020200397.

scholarly journals The Relationship between the Number of Daily Health-Related Behavioral Risk Factors and Sleep Health of the Elderly in China

2019 ◽  
Vol 16 (24) ◽  
pp. 4905 ◽  
Author(s):  
Xiaojun Liu ◽  
Jingshu Chen ◽  
Jiayi Zhou ◽  
Jianjian Liu ◽  
Chanida Lertpitakpong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sleep Quality ◽  
Risk Behaviors ◽  
Regression Models ◽  
Sleep Disturbances ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Related Risk ◽  
Health Related ◽  
Multiple Health

This study examined the cross-sectional association among a number of daily health-related behavioral risk factors and sleep among Chinese elderly. A sample of 4993 adults, aged 60 years and older, from the China’s Health-Related Quality of Life Survey for Older Adults 2018 was included in this study. Five daily health-related behaviors, which included smoking, drinking, unhealthy eating habits, insufficient leisure activities, and physical inactivity were measured. Sleep disturbances and sleep quality were used to represent the respondents’ sleep status. Multiple logistic regression models and multiple linear regression models were established. The odds ratios (ORs) of sleep disturbances for those with one to five health-related risk behaviors were 1.41 (95% CI = 1.11 to 1.78), 2.09 (95% CI = 1.66 to 2.63), 2.54 (95% CI = 1.99 to 3.25), 2.12 (95% CI = 1.60 to 2.80), and 2.49 (95% CI = 1.70 to 3.65), respectively. Individuals with one health-related risk behavior (B = 0.14, 95% CI = −0.23 to −0.06), two health-related risk behaviors (B = 0.21, 95% CI = −0.30 to −0.13), three health-related risk behaviors (B = 0.46, 95% CI = −0.55 to −0.37), four health-related risk behaviors (B = 0.50, 95% CI = −0.62 to −0.39), and five health-related risk behaviors (B = 0.83, 95% CI = −1.00 to −0.66) showed lower scores of self-perceived sleep quality. Having multiple health-risk behaviors was positively correlated with a higher risk of sleep disturbances among Chinese elderly. Moreover, elderly individuals with multiple health-related risk behaviors were significantly associated with poorer sleep quality.

scholarly journals Sleep in Intensive Care Unit Patients

2021 ◽  
Vol 18 (2) ◽  
pp. 66-71
Author(s):  
Jin Park
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Objective Evaluation ◽  
Continuous Exposure ◽  
Sleep Analysis ◽  
Improve Sleep Quality ◽  
Seriously Ill Patients

Sleep disturbances are common among patients admitted to the intensive care unit (ICU); however, these issues tend to receive less attention because critical care is prioritized in seriously ill patients. Recent studies have reported that sleep disturbances in patients admitted to the ICU are associated with delirium, weakened immunity, long-term cognitive decline, and persistent sleep disorders. Sleep disturbances in the ICU are attributable to the disease per se and also to the ICU environment that is not conducive to good sleep. Continuous exposure to light and noise are major environmental risk factors that disrupt the circadian rhythm and interfere with deep sleep. Sleep analysis using polysomnography in patients admitted to the ICU typically reveals increase in sleep latency, sleep fragmentation, and decreased stage N3 and rapid eye movement sleep, which are associated with poor prognosis even in patients with severe neurological conditions, including traumatic brain injury and intracranial hemorrhage. Polysomnography is the gold standard for objective evaluation of sleep; however, its applicability is limited in ICU settings, and novel methods such as continuous electroencephalographic spectral analysis and actigraphy have recently been proposed in clinical practice. Efforts to reduce nighttime light and noise (which are modifiable environmental factors) can improve sleep quality. In this article, the author reviews the studies that discuss characteristics of sleep disturbances, the associated risk factors and their correlation with prognosis among patients admitted to the ICU, as well as possible strategies to improve sleep quality in this patient population.

scholarly journals Risk Factors for Moderate-to-severe Postoperative Pain After Percutaneous Nephrolithotomy:A Retrospective Study

2021 ◽  
Author(s):  
Hao-Tian Wu ◽  
Tian-fu Ding ◽  
Huan Zhang
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Multivariate Logistic Regression Analysis ◽  
Renal Calculus ◽  
Multivariate Logistic Regression ◽  
Pain Group ◽  
Duration Of Surgery ◽  
Severe Postoperative Pain

Abstract Backgroud and Objectives: Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure for removing renal calculus ,but a large number of patients experience acute moderate-to-severe pain despite the analgesia provided.The aim of this study is to explore the risk factors for postoperative pain after percutaneous nephrolithotomy (PCNL), and provides a reference for clinical prevention of postoperative pain after PCNL.Methods: According to the inclusion and exclusion criteria, the clinical data of 331 patients who underwent PCNL in our hospital from September 2019 to February 2021 were retrospectively collected. General anesthesia was induced with propofol, sufentanil and rocuronium and maintained with sevoflurane, remifentanil and rocuronium.Depending on whether the patient had moderate-to-severe postoperative pain, they were divided into mild or no pain group and moderate-to-severe pain group. We collected and analyzed data on age,gender, body mass index (BMI),ASA grading,co-morbidities,number of renal calculus,renal calculus size,degree of hydronephrosis,preoperative urine culture,preoperative creatinine,stone burdens,expansion method,tract diameter,nephrostomy tube,calculi residual,operative position ,puncture time ,number of expanded channels,expanded channel time, duration of surgery,vital signs and VAS pain score.The indicators with statistically significant differences were selected and multivariate logistic regression analysis was carried out to determine the risk factors for postoperative pain. Results: Among 331 patients, 221 had moderate-to-severe pain and the incidence rate was 66.77%. Univariate analysis and multivariate logistic regression analysis showed that independent risk factors for moderate-to-severe pain after PCNL were:number of renal calculus(OR=5.303，P=0.001),stone burdens (OR=7.623，P=0.001),calculi residual(OR=0.2377，P=0.001),duration of surgery (min)(OR=1.024， P=0.001). Conclusions: The main risk factors for pain after PCNL are number of renal calculus,stone burdens ,calculi residual and duration of surgery.

scholarly journals Prevalence of Sleep Disturbances During COVID-19 Pandemic in a Nepalese Population: A Cross-Sectional Study

2021 ◽  
Vol 18 (3) ◽  
pp. 145-153
Author(s):  
Avinash Chandra ◽  
Pooja Prakash ◽  
Nabina Sharma ◽  
Ayush Chandra
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Sectional Study ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
Insomnia Severity

Objectives: The coronavirus disease (COVID-19) pandemic and news of daily increasing cases inside Nepal and worldwide is adding to the fear that leads to anger, anxiety, frustration, and stress, emotions that directly affect sleep quality. This study aimed to assess sleep disturbances during the COVID-19 pandemic in a Nepalese population.Methods: This cross-sectional study recruited 206 Nepali residents who completed anonymous self-administered questionnaires. The Insomnia Severity Index (ISI) questionnaire was used to measure sleep disturbances before and after the COVID-19 pandemic. The gathered data were analyzed using descriptive statistics and inferential statistics using SPSS version 20 statistical software.Results: There was a significant variation in sleep disturbances among Nepalese residents before versus after the COVID-19 pandemic (p<0.001). The prevalence of clinical moderate insomnia has increased tremendously in Nepalese individuals. Before the pandemic’s onset, only 3.9% of the participants had moderate to severe levels of clinical insomnia; after its onset, this value increased to 17.5%. The mean ISI scores were 6.35±4.65 and 8.01±6.01 before and after the pandemic’s onset, respectively.Conclusions: Our study findings suggest that people are suffering tremendously with sleep disturbances and calls for further research and active measures to help increase sleep quality during the COVID-19 pandemic.

scholarly journals Nutritional Interventions to Improve Sleep in Team-Sport Athletes: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1586
Author(s):  
Madeleine Gratwicke ◽  
Kathleen H. Miles ◽  
David B. Pyne ◽  
Kate L. Pumpa ◽  
Brad Clark
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Early Morning ◽  
Vital Role ◽  
Narrative Review ◽  
Poor Sleep ◽  
Carbohydrate Ingestion ◽  
Nutritional Interventions ◽  
Nutrition Research ◽  
Improve Sleep Quality

Athletes often experience sleep disturbances and poor sleep as a consequence of extended travel, the timing of training and competition (i.e., early morning or evening), and muscle soreness. Nutrition plays a vital role in sports performance and recovery, and a variety of foods, beverages, and supplements purportedly have the capacity to improve sleep quality and quantity. Here, we review and discuss relevant studies regarding nutrition, foods, supplements, and beverages that may improve sleep quality and quantity. Our narrative review was supported by a semi-systematic approach to article searching, and specific inclusion and exclusion criteria, such that articles reviewed were relevant to athletes and sporting environments. Six databases—PubMed, Scopus, CINAHL, EMBASE, SPORTDiscus, and Google Scholar—were searched for initial studies of interest from inception to November 2020. Given the paucity of sleep nutrition research in the athlete population, we expanded our inclusion criteria to include studies that reported the outcomes of nutritional interventions to improve sleep in otherwise healthy adults. Carbohydrate ingestion to improve sleep parameters is inconclusive, although high glycemic index foods appear to have small benefits. Tart cherry juice can promote sleep quantity, herbal supplements can enhance sleep quality, while kiwifruit and protein interventions have been shown to improve both sleep quality and quantity. Nutritional interventions are an effective way to improve sleep quality and quantity, although further research is needed to determine the appropriate dose, source, and timing in relation to training, travel, and competition requirements.

Waking Up in Pain: a prospective unselected cohort study of pain in 3702 patients immediately after surgery in the Danish Realm

2021 ◽  
pp. rapm-2021-102583 ◽  
Author(s):  
Anders Mølgaard Rasmussen ◽  
Mette Helene Toft ◽  
Hussein Nasser Awada ◽  
Jesper Dirks ◽  
Birgitte Brandsborg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Large Scale ◽  
Public Hospitals ◽  
Postanesthesia Care Unit ◽  
Postoperative Phase ◽  
Preoperative Pain ◽  
Unselected Cohort

BackgroundAcute and persistent pain after surgery is well described. However, no large-scale studies on immediate postoperative pain in the operating room (OR) exist, hindering potential areas of research to improve clinical outcomes. Thus, we aimed to describe the occurrence and severity of immediate postoperative pain in a large, unselected cohort.MethodsThis was a prospective cohort study, encompassing all procedures in 31 public hospitals in the Danish Realm, during a 5-day period including the weekend. Data on procedures and anesthesia were collected and the main outcome was occurrence of moderate or severe pain in the OR. Secondary outcomes included pain, sedation and nausea in the OR or during the first 15 min in the postanesthesia care unit (PACU) including relevant risk factors. Descriptive and logistic regression statistics were used.ResultsA total of 3675 procedures were included for analysis (87% inclusion rate). Moderate or severe pain occurred in 7.4% (95% CI 6.5% to 8.3%) of cases in the OR immediately after awakening, rising to 20.2% in the OR and/or PACU. Large intraprocedure and interprocedure variations occurred (0.0%–37.5%), and in 20% of cases with epidural-general anesthesia patients experienced moderate or severe pain. Independent risk factors were female sex, younger age, preoperative pain, daily opioid use and major surgical procedures.ConclusionModerate or severe pain in the immediate postoperative phase occurred in 20% of all cases with procedure and anesthesiological technique variations, suggesting a need for identification of relevant procedure-specific risk factors and development of preventive treatments.Trial registration numberRoPR ID 43191.

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