The impact of sleep duration on recovery post-hip fracture among older diabetic adults in Taiwan

Predictors of Abnormal Sleep Duration in Older Adults With Hip Fracture and Diabetes

“…We applied G*Power with a logistic regression model to calculate posterior power using the current adjusted odds ratio generalized estimating equations (GEE) model parameters (Lu et al, 2013). During the sixth month after surgery, older adults with hip fractures had better recovery and sleep conditions (Kuo et al, 2016; Shyu et al, 2004). In addition, because a correlation between DM complications and sleep conditions is supported in the literature (Khandelwal et al, 2017), the abnormal sleep duration incident rate was used in the sixth month after discharge together with predictive factors, including DPN and diabetes-related peripheral vascular disease, to calculate posterior power.…”

“…In addition, a number of prior studies have defined abnormal sleep duration to include both short and long sleep durations (Gershon et al, 2017; Kuo et al, 2016). In this study, “normal sleep duration” was defined as those with sleep durations of 6.1–8.9 hours per day and “abnormal sleep duration” was defined as those with sleep durations of ≤ 6 hours per day or ≥ 9 hours per day (Gershon et al, 2017; Kuo et al, 2016). The results of prior research support SenseWear as a more reliable method for assessing sleep in patients with obstructive sleep apnea than the current gold standard test (polysomnography; Sharif & Bahammam, 2013).…”

“…A previous study found that older adults with hip fracture and DM had poorer recovery outcomes after surgery than those without DM (Tebé et al, 2019). One study found 63%-68% of older adults with both hip fracture and DM were affected by abnormal sleep duration during the 6 months after hospital discharge (Kuo et al, 2016). Moreover, those with abnormal sleep duration (≤ 6 hours per day or ≥ 9 hours per day) had worse femoral muscle recovery on the fractured side and poorer blood glucose control than those with normal sleep duration (6.1-8.9 hours per day) during recovery from hip fracture (Kuo et al, 2016).…”

Relevance of Sleep Disturbances to Orthopaedic Surgery

“…Difficulty lying on the affected side, inadvertently rolling onto that side during sleep, having to change his or her sleeping position even a year after the injury, anxiety, fatigue, and sleepiness attributed to medication were some common symptoms reported as important 71,72 . Furthermore, in a study of elderly diabetic patients recovering from a hip fracture, those who exhibited abnormal sleep duration (£6 hours or ‡9 hours), as measured via actigraphy, in at least 2 of 3 observations at 1, 3, and/or 6 months after discharge, showed reduced range of motion of the hips and muscle power during quadriceps contraction on the affected side in comparison with those with normal sleep duration 14 . In surgical contexts, a randomized controlled trial (RCT) with 148 patients evaluated the impact of prescribing zolpidem to improve sleep quality after total knee arthroplasty (TKA) 73 .…”

“…Moreover, previous evidence has linked poor sleep and disruption in circadian cycles with decreased bone mineral density (BMD) 10,11 , a critical factor associated with other risk factors for fractures such as osteoporosis and bone fragility 12 . In addition, sleep problems are linked with acute and chronic pain, which are important outcomes in the context of an orthopaedic traumatic injury and can interfere with functional and physical recovery after injury 13,14 .…”