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

Qiong Chen; Yanchun Peng; Yanjuan Lin; Sailan Li; Xizhen Huang; Liang-Wan Chen

doi:10.2147/NSS.S275698

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

Nat Sci Sleep. 2020 Dec 8:12:1137-1144. doi: 10.2147/NSS.S275698. eCollection 2020.

Authors

Qiong Chen¹, Yanchun Peng², Yanjuan Lin³, Sailan Li², Xizhen Huang², Liang-Wan Chen²

Affiliations

¹ Department of Nursing, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
² Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
³ Department of Nursing, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.

Abstract

Purpose: 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: atypical sleep; cardiac surgery; intensive care unit; postoperative delirium.

Grants and funding

This work was supported by the Joint Finds for the Innovation of Science and Technology, Fujian province (Grant number: 2017Y9052) and the Guiding Project of Fujian Science and Technology (2017Y0038).