title: Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement.
abstract: BACKGROUND
  Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase.
  
  
  OBJECTIVE
  To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep-wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI.
  
  
  METHODS
  A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep-wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days.
  
  
  RESULTS
  SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p < 0.01).
  
  
  CONCLUSIONS
  Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep-wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
authors.forename: Hege Andersen
authors.initials: HA
authors.lastname: Amofah
authors.affiliation: Institute of Nursing, Faculty of Health and Social Science, Bergen University College, Norway School of Health Sciences, Jönköping University, Sweden Department of Clinical Neurophysiology, Linkoping University Hospital, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Broström
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Institute of Nursing, Faculty of Health and Social Science, Bergen University College, Norway School of Health Sciences, Jönköping University, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
authors.affiliation: Norwegian Competence Centre for Sleep Disorders, Bergen, Norway Department of Global Public Health and Primary Care, University of Bergen, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Bjorvatn
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Department of Clinical Science, University of Bergen, Norway.
authors.forename: Rune
authors.initials: R
authors.lastname: Haaverstad
authors.affiliation: Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
authors.forename: Karl Ove
authors.initials: KO
authors.lastname: Hufthammer
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
authors.forename: Karel Kj
authors.initials: KK
authors.lastname: Kuiper
authors.affiliation: Department of Clinical Science, University of Bergen, Norway Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Hospital, Bergen, Norway.
authors.forename: Anette Hylen
authors.initials: AH
authors.lastname: Ranhoff
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Institute of Nursing, Faculty of Health and Social Science, Bergen University College, Norway Department of Clinical Science, University of Bergen, Norway tone.norekval@helse-bergen.no.
authors.forename: Tone M
authors.initials: TM
authors.lastname: Norekvål
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D057566:Self Report; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome
keywords: Aortic stenosis; SAVR; TAVI; in-hospital sleep; octogenarian