The Effect of Preoperative Sleep Quality on Postoperative Delirium in Middle-Aged and Elderly Patients: A Clinical...

To investigate the impact of preoperative sleep quality on postoperative delirium in adults aged 45-64 years and those aged over 65 years undergoing general anaesthesia.

An observational study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Konya, Turkiye, from August to December 2023.

Patients aged 45-64 years and those aged ≥65 years who underwent surgeries lasting more than 2 hours under general anaesthesia were assigned to age groups solely according to their chronological age and were observed during routine clinical care. Preoperatively, the STOP-Bang questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Mini-Mental State Examination (MMSE) were administered. Intraoperative and postoperative parameters were recorded. Postoperatively, the PSQI and QoR-15 were reassessed, and delirium screening was performed daily for 72 hours using the 3D-CAM and ICU-CAM tools. Patients discharged early were followed up by phone. Continuous variables were compared using the independent t-test or Mann-Whitney U test, depending on data distribution, and categorical variables were analysed using the chi-square or Fisher's exact test. A p-value of <0.05 was considered statistically significant.

In the ward setting, a comparison between the two groups revealed no statistically significant variation in the frequency of postoperative delirium among the 150 patients (p = 0.248) or ICU (p = 0.471). However, the patients aged over 65 years, with poor preoperative sleep quality (PSQI >5), showed a significant correlation with ICU delirium (p = 0.03).

Poor preoperative sleep quality in elderly patients is associated with increased risk of postoperative delirium. These findings warrant further study.

Delirium, General anaesthesia, Sleep quality, Age, Pittsburgh Sleep Quality Index, Postoperative outcomes.