title: Sleeping characteristics of adults undergoing outpatient elective surgery: a cohort study.
abstract: OBJECTIVE
  To describe sleeping patterns of adults before and after outpatient surgery.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Outpatient surgical facility.
  
  
  METHODS
  127 consenting adults, including 92 surgery patients and 35 community controls.
  
  
  METHODS
  Participants' sleep was measured for two days before and 2 days after outpatient surgery.
  
  
  METHODS
  Sleep was measured using actigraphy; additional measurements were made of anxiety (STAI), pain and energy (VAS), recovery (PHRI), and sleep history.
  
  
  RESULTS
  Approximately 23% of patients experienced clinically significant sleep impairment after surgery, a more difficult recovery, increased pain, and lower energy. In contrast, only 2.9% of the community control group experienced clinically significant sleep impairment during the same time period. Also, patients in the surgery group experienced significantly more True Wake Time postoperatively than did control patients (p = 0.029). The surgery group also experienced more Night Awakenings >5 minutes than the control group (p = 0.006), but not more overall Night Awakenings (p = 0.106). Finally, of the patients in the surgery group, those who had higher state anxiety in the holding area also had more difficulty sleeping over the 4-day monitoring period (True Sleep Time was lower, 352 +/- 187 vs. 229 +/- 225, p = 0.009).
  
  
  CONCLUSIONS
  A moderate proportion of adults experience postoperative sleeping problems.
authors.affiliation: Department of Anesthesiology, Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA. kain@biomed.med.yale.edu
authors.forename: Zeev N
authors.initials: ZN
authors.lastname: Kain
authors.forename: Alison A
authors.initials: AA
authors.lastname: Caldwell-Andrews
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D001007:Anxiety / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires