title: Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair.
abstract: BACKGROUND
  Sleep disturbance is a common complaint of patients with a rotator cuff tear. Inadequate and restless sleep, along with pain, is often a driving symptom for patients to proceed with rotator cuff repair. To date, no studies have examined sleep disturbance in patients undergoing rotator cuff repair, and there is no evidence that surgery improves sleep disturbance.
  
  
  OBJECTIVE
  Sleep disturbance is prevalent in patients with a symptomatic rotator cuff tear, and sleep disturbance improves after arthroscopic rotator cuff repair.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  A total of 56 patients undergoing arthroscopic rotator cuff repair for full-thickness tears were enrolled in a prospective study. Patients were surveyed preoperatively and postoperatively at intervals of 2, 6, 12, 18, and 24 weeks. Patient outcomes were scored using the Pittsburgh Sleep Quality Index (PSQI), Simple Shoulder Test (SST), visual analog scale for pain (VAS), and single assessment numeric evaluation (SANE). Demographic and surgical factors were also collected for analysis.
  
  
  RESULTS
  Preoperative PSQI scores indicative of sleep disturbance were reported in 89% of patients. After surgery, a statistically significant improvement in PSQI was achieved at 3 months (P = .0012; 91% follow-up) and continued through 6 months (P = .0179; 93% follow-up). Six months after surgery, only 38% of patients continued to have sleep disturbance. Multivariable linear regression of all surgical and demographic factors versus PSQI was performed and demonstrated that preoperative and prolonged postoperative narcotic use negatively affected sleep.
  
  
  CONCLUSIONS
  Sleep disturbance is common in patients undergoing rotator cuff repair. After surgery, sleep disturbance improves to levels comparable with those of the general public. Preoperative and prolonged postoperative use of narcotic pain medication negatively affects sleep.
authors.affiliation: Rothman Institute of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA lukesaustin@gmail.com.
authors.forename: Luke
authors.initials: L
authors.lastname: Austin
authors.affiliation: Rothman Institute of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Pepe
authors.affiliation: Rothman Institute of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Bradford
authors.initials: B
authors.lastname: Tucker
authors.affiliation: Rothman Institute of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Alvin
authors.initials: A
authors.lastname: Ong
authors.affiliation: Rothman Institute of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Nugent
authors.affiliation: Rothman Institute of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Eck
authors.affiliation: Rothman Institute of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Fotios
authors.initials: F
authors.lastname: Tjoumakaris
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery; D012893:Sleep Wake Disorders / Q000209:etiology*; D016896:Treatment Outcome
keywords: aging athlete; rotator cuff; shoulder; sleep