Poor Sleep Quality Linked to Higher Postoperative Delirium Risk, Study Finds

New research presented at the ANESTHESIOLOGY 2024 annual meeting shows a significant link between poor sleep quality in the month leading up to surgery and a heightened risk of postoperative delirium. The findings emphasize the importance of prioritizing sleep health before surgery, particularly for older adults who are already more susceptible to this cognitive complication.

The study is one of the first to specifically examine the role of sleep quality in postoperative delirium, a condition characterized by temporary confusion and altered mental function. This cognitive change affects up to 15% of surgical patients, with higher rates observed in high-risk groups, such as those undergoing hip fracture repair. Researchers from the Cleveland Clinic Foundation’s Outcomes Research Consortium evaluated 150 patients undergoing non-cardiac surgeries lasting over two hours. The patients assessed their pre-surgery sleep quality using the Pittsburgh Sleep Quality Index (PSQI), which evaluates sleep duration, efficiency, and disturbances.

The study results demonstrated a notable increase in delirium rates among patients with poor preoperative sleep. Specifically, 25% of patients with poor sleep quality (scoring above 5 on the PSQI) developed postoperative delirium, compared to 17.9% of those with better sleep quality. The likelihood of experiencing delirium was 39.66% higher in individuals with poor sleep, highlighting the potential protective role of quality sleep in the surgical recovery process.

This association between pre-surgery sleep quality and postoperative mental health introduces a potential avenue for reducing delirium risk, especially in patients over 65, who are the most vulnerable to this complication. Dr. Faegheh Miryousefiata, the study’s lead author, noted that good sleep quality before surgery is essential for a smoother recovery period. She recommended that healthcare providers emphasize sleep optimization benefits to patients, particularly those at higher risk.

To support better sleep quality before surgery, the researchers suggest strategies such as maintaining consistent sleep-wake schedules, developing a relaxing bedtime routine, and minimizing screen exposure in the evening. They also advocate for stress-management practices, such as mindfulness or deep breathing exercises, which may help reduce preoperative anxiety and improve overall sleep quality. Focusing on these preoperative sleep practices may aid patients in experiencing smoother recoveries and potentially lower the risk of cognitive issues following surgery.