Sleep and circadian biomarkers of postoperative delirium: protocol for a prospective, observational cohort study

Sugg, Elizabeth; Gleeson, Elizabeth; Baker, Sarah N.; Li, Peng; Gao, Chenlu; Mueller, Ariel; Deng, Hao; Shen, Shiqian; Franco Garcia, Esteban; Saxena, Richa; Musiek, Erik; Akeju, Oluwaseun; Xie, Zhongcong; Hu, Kun; Gao, Lei

doi:10.1101/2023.09.21.23295920

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Given the potential discrepancies between subjective sleep quality ratings and objective sleep assessments, and considering that the complexity of polysomnography monitoring may disrupt patients' sleep, future studies should consider using wearable electronic monitoring devices equipped with various eye and hand movement sensors. [77][78][79] Thirdly, the potential influence of time as a confounding factor on sleep quality was not explored. Additionally, the absence of involvement of a biostatistician in the analysis process poses another limitation.…”

Section: Dovepressmentioning

confidence: 99%

Association Between Preoperative Sleep Disturbance and Postoperative Delirium in Elderly: A Retrospective Cohort Study

Guo,

Li,

et al. 2024

NSS

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Postoperative sleep disturbance, characterized by diminished postoperative sleep quality, is a risk factor for postoperative delirium (POD); however, the association between pre-existing sleep disturbance and POD remains unclear. This study aimed to evaluate the association between preoperative sleep disturbance and POD in elderly patients after non-cardiac surgery. Patients and methods: This retrospective cohort study was conducted at a single center and enrolled 489 elderly patients who underwent surgery between May 1, 2020, and March 31, 2021. Patients were divided into the sleep disorder (SD) and non-sleep disorder (NSD) groups according to the occurrence of one or more symptoms of insomnia within one month or sleep-Numerical Rating Scale (NRS)≥6 before surgery. The primary outcome was the incidence of POD. Propensity score matching analysis was performed between the two groups. Multiple logistic regression analysis was performed to identify the risk factors for POD. Results: In both the unmatched cohort (16.0% vs 6.7%, P=0.003) and the matched cohort (17.0% vs 6.2%, P=0.023), the incidence of POD was higher in the SD group than in the NSD group. In addition, the postoperative sleep quality and the VAS score at postoperative 24 h were significantly lower in the SD group than in the NSD group. Multivariate logistic regression analysis indicated that age (Odds Ratio, 1.13 [95% CI: 1.04-1.23], P=0.003) and preoperative sleep disturbance (Odds Ratio, 3.03 [95% CI: 1.09-9.52], P=0.034) were independent risk factors for the development of POD. Conclusion: The incidence of POD was higher in patients with pre-existing sleep disturbance than those without it. Whether improving sleep quality for preoperative sleep disturbance may help prevent POD remains to be determined.

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Section: Dovepressmentioning

confidence: 99%

Association Between Preoperative Sleep Disturbance and Postoperative Delirium in Elderly: A Retrospective Cohort Study

Guo,

Li,

et al. 2024

NSS

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Associations of Rest‐Activity Rhythm Disturbances With Stroke Risk and Poststroke Adverse Outcomes

Gao,

Zheng,

Baker

et al. 2024

JAHA

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Background Many disease processes are influenced by circadian clocks and display ~24‐hour rhythms. Whether disruptions to these rhythms increase stroke risk is unclear. We evaluated the association between 24‐hour rest‐activity rhythms, stroke risk, and major poststroke adverse outcomes. Methods and Results We examined ~100 000 participants from the UK Biobank (aged 44–79 years; ~57% women) assessed with actigraphy (6–7 days) and 5‐year median follow‐up. We derived (1) most active 10‐hour activity counts across the 24‐hour cycle and the timing of its midpoint timing; (2) the least active 5‐hour count and its midpoint; (3) relative amplitude; (4) interdaily stability; and (5) intradaily variability, for stability and fragmentation of the rhythm. Cox proportional hazard models were constructed for time to (1) incident stroke (n=1652) and (2) poststroke adverse outcomes (dementia, depression, disability, or death). Suppressed relative amplitude (lowest quartile [quartile 1] versus the top quartile [quartile 4]) was associated with stroke risk (hazard ratio [HR], 1.61 [95% CI, 1.35–1.92]; P <0.001) after adjusting for demographics. Later most active 10‐hour activity count midpoint timing (14:00–15:26; HR, 1.26 [95% CI, 1.07–1.49]; P =0.007) also had higher stroke risk than earlier (12:17–13:10) participants. A fragmented rhythm (intradaily variability) was also associated with higher stroke risk (quartile 4 versus quartile 1; HR, 1.26 [95% CI, 1.06–1.49]; P =0.008). Suppressed relative amplitude was associated with risk for poststroke adverse outcomes (quartile 1 versus quartile 4; HR, 2.02 [95% CI, 1.46–2.48]; P <0.001). All associations were independent of age, sex, race, obesity, sleep disorders, cardiovascular diseases or risks, and other comorbidity burdens. Conclusions Suppressed 24‐hour rest‐activity rhythm may be a risk factor for stroke and an early indicator of major poststroke adverse outcomes.

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Sleep and circadian biomarkers of postoperative delirium: protocol for a prospective, observational cohort study

Cited by 2 publications

References 21 publications

Association Between Preoperative Sleep Disturbance and Postoperative Delirium in Elderly: A Retrospective Cohort Study

Association Between Preoperative Sleep Disturbance and Postoperative Delirium in Elderly: A Retrospective Cohort Study

Associations of Rest‐Activity Rhythm Disturbances With Stroke Risk and Poststroke Adverse Outcomes

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