Nature and Science of Sleep (Dec 2020)

Atypical Sleep and Postoperative Delirium in the Cardiothoracic Surgical Intensive Care Unit: A Pilot Prospective Study

  • Chen Q,
  • Peng Y,
  • Lin Y,
  • Li S,
  • Huang X,
  • Chen LW

Journal volume & issue
Vol. Volume 12
pp. 1137 – 1144

Abstract

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Qiong Chen,1 Yanchun Peng,2 Yanjuan Lin,3 Sailan Li,2 Xizhen Huang,2 Liang-Wan Chen2 1Department of Nursing, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 3Department of Nursing, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People’s Republic of ChinaCorrespondence: Yanjuan LinDepartment of Nursing, Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou, 350001 Fujian Province, People’s Republic of ChinaTel +86 59186218581Fax +86 83344034Email [email protected] ChenDepartment of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, People’s Republic of ChinaTel +86 59186218581Fax +86 59183301393Email [email protected]: Postoperative delirium (POD) is a very common and serious neurological complication in patients admitted to the cardiothoracic surgical intensive care unit (CSICU). We aimed to identify a novel potential sleep-based marker for POD and investigate the relevance between atypical sleep and POD.Patients and Methods: This was a prospective, observational study of patients admitted to the CSICU between December 2019 and February 2020 at our center. Sleep characteristics from 21:00 on postoperative day 1 to 07:00 on postoperative day 2 were assessed using polysomnography (PSG). POD from the end of PSG monitoring until postoperative day 5 was evaluated using the Confusion Assessment Method for the Intensive Care Unit.Results: This analysis included 20 patients admitted to the CSICU. The incidence of atypical sleep was 45.0%. Compared to patients without delirium, those with delirium had less delta power, less percentage REM sleep, and a higher proportion of atypical sleep and REM sleep loss (P < 0.05).Conclusion: The presence of atypical sleep and the absence of REM sleep were associated with POD in patients admitted to the CSICU.Keywords: postoperative delirium, intensive care unit, atypical sleep, cardiac surgery

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