Sleep Disturbance and Rotator Cuff Tears: A Systematic Review

Abstract

Background and Objectives: Sleep disorders are one of the most common complaints of patients with rotator cuff (RC) tears. However, potential correlations between the treatment of RC tears and the causal factors of sleep disorders are still under discussion. The aim of this review is to evaluate quality of sleep in patients before and after surgery for RC tears and to identify which factors affected patients’ sleep. Materials and Methods: A systematic review was conducted. To provide high quality of the review, the included studies were evaluated with the standardized tool “Quality Assessment Tool for Quantitative Studies” developed by the Effective Public Health Practice Project. Results: The search strategy yielded 78 articles. After duplicate removal and titles, abstracts and full-texts review, four studies were included in the systematic review. Concerning shoulder function, the most frequently reported scale was the Simple Shoulder Test (SST). Regarding sleep quality, the most frequently reported score was the Pittsburgh Sleep Quality Index (PSQI). Conclusion: We found that the majority of patients with RC tears had a sleep disturbance, especially before surgery with a general improvement in sleep quality post-operatively. Moreover, sleep quality was correlated with pain and it also seems that factors as comorbidities, obligatory position during night time, preoperative and prolonged postoperative use of narcotics and psychiatric issues may play an important role in sleep quality.

Scapular Dyskinesis: From Basic Science to Ultimate Treatment

“…Like GH instability, impingement affects the optimal relation between glenoid alignment and the muscle length-tension relationship during arm elevation, with a greater loss of shoulder function [14,15,74]. Displaced clavicular fractures make more common the development of painful SD, and they negatively affect clinical outcomes in comparison to subjects without SD [75,76]. Even if not all clavicular fractures are related to altered shoulder motion, SD is present in the long-term after total claviculectomy [77,78].…”

Cost-Effectiveness of Supervised versus Unsupervised Rehabilitation for Rotator-Cuff Repair: Systematic Review and Meta-Analysis

“…Indeed, not only type of injury, but also several parameters, such as tear size and location [35], surgical technique [36][37][38][39], and concomitant pathologies [21,30,40], may influence the recovery of shoulder function [24,41]. Therefore, only an individualized and supervised rehabilitation program can consider all patient-and surgical-based variables on the basis of which specific exercise programs could be designed [13,39]. However, Hayes et al showed comparable outcomes in patients who had undergone individualized, supervised rehabilitation, and patients who had performed standard unsupervised exercises at home [24].…”

“…For instance, sleep disorders are among the most frequent complaints of patients with RC tears. Recent studies highlighted the impact that other human variables, such as sleep quality, patient expectation, cognitive, affective psychologic factors or distress, and socioeconomic status may have on the clinical results of RC tears [13,[43][44][45][46][47][48][49][50][51].…”

“…Surgery alone is often inadequate to guarantee the satisfactory return of complete shoulder function. In the postoperative period, patients often complain of limitations in active movements, and pain in the neck and the involved muscles [13]. Therefore, a correct rehabilitation period, aimed to restore the shoulder function and avoid the risk of retear, is essential [14].…”

Evaluation of three-dimensional acromiohumeral distance in the standing position and comparison with its conventional measuring methods

“…The individual differences in 3D AHD between the standing and supine positions also varied widely, by up to 4.9 mm, suggesting that the alignment changes in the glenohumeral joint between positions varies between individuals. In cases of rotator cuff tear, the patients often suffer from pain at night and sleep disturbance when lying in the supine position 19 ; therefore, Railhac et al 20 stated that measuring AHD in the supine position is useful in detecting a rotator cuff tear. Different positions can change the subacromial pressure, 21,22 and the narrowing of the AHD in the supine position might increase pain.…”