Postoperative Sleep Interventions and Cardiac Surgery: A Systematic Review and Meta-Analysis

Sleep disturbance is a common issue affecting nearly 78% of cardiothoracic postoperative patients. There are no systematic reviews of randomised controlled trials (RCTs) that evaluate the impact of sleep interventions within this population. This study aims to evaluate the sleeping patterns in post-operative cardiac surgery patients and identify if sleep interventions improve sleep quality. The primary outcomes were subjective and objective measures of sleep using the Pittsburgh Sleep Quality Index (PSQI) in addition to the duration of intensive care unit (ICU) and hospital admission.

Searches on PubMed, Medline, Embase, Scopus and Cochrane were undertaken from database inception to 24 February 2023. Only RCTs that recorded a sleep intervention in addition to standardised sleep scoring measures in adult cardiac surgical patients were included.

A total of 26 studies were included (n = 2323). Total PSQI score had a statistically significant standardised mean difference (SMD) between intervention and control groups for improved scores as indicated by the SMD of -0.73 (95% CI; -0.93; -0.52, p = 0.04). The duration of ICU admission had a SMD of -0.23 (95% CI; -0.50 to 0.03, p = 0.19) and was not statistically significant. Similarly, the duration of hospital admission had a SMD of -1.10 (95% CI; -2.56 to 0.37, p = < 0.01) and was not statistically significant.

Whilst sleep interventions did not have a statistically significant effect on the duration of ICU or hospital admission, they did show a significant improvement in sleep quality as reported through the PSQI total score.