Preoperative sleep quality and adverse pain outcomes after total hip arthroplasty

Abstract

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Response to: ‘The relationship between preoperative sleep quality and adverse pain outcomes is still unclear—A comment on Bjurström et al.’

“…Congruent with results from the referenced systematic review by O'Hagan et al, we have also found that perioperative pharmacologic sleep promotion may improve postoperative pain control . Our results demonstrated a connection between poor preoperative sleep quality and adverse postoperative pain outcomes, which strengthens prior evidence of a causal relationship between sleep and pain (Bjurstrom et al, 2021). We acknowledge, however, as stated in 'Limitations and recommendations for future studies', that longitudinal objective sleep data (actigraphy and/or polysomnography) would add specificity to these findings.…”

The relationship between preoperative sleep quality and adverse pain outcomes is still unclear: A Comment on Bjurström et al.

“…We note with interest the recently published observational study by Bjurström et al titled: 'Preoperative sleep quality and adverse pain outcomes after total hip arthroplasty'. The authors conclude by suggesting 'targeting sleep and achieving even modest improvements in sleep might translate into meaningful clinical improvements in pain' (Bjurström et al, 2021). To their credit, the authors are cautious while presenting this conclusion.…”

Stress-induced changes in nociceptive responding post-surgery in preclinical rodent models

“…Perioperative sleep disturbance is a risk factor for the development of persistent pain after surgery ( 44 – 46 ). Pre-clinically, a single pre-operative exposure to REM sleep deprivation/disturbance (RSD) for 6 h has been shown to enhance mechanical hypersensitivity in female rats on day 3–4 post-surgery ( 25 ), while pre- or peri-operative RSD for 24 h or 3 days (6 h/day) increases mechanical, thermal and cold hypersensitivity in male rats for up to 9 days post paw-incision surgery ( 22 – 24 ) ( Table 1 ).…”