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Sleeping Patterns in Patients Undergoing Total Knee Arthroplasty: A Prospective Study Using a Wearable Device.

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Total knee arthroplasty (TKA) patients experience the worst perceived sleep quality between weeks two and four after surgery, while objective data shows the poorest sleep in the first week. Pre-existing sleep disorders did not worsen outcomes.

Keywords:
outcomespatient-reported outcomesremote monitoringsleeptotal knee arthroplastywearable devices

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Area of Science:

  • Orthopedics
  • Sleep Medicine
  • Arthroplasty Research

Background:

  • Sleep disturbances are common and poorly understood following total knee arthroplasty (TKA).
  • Characterizing perioperative sleep patterns is crucial for patient recovery.
  • Understanding factors influencing sleep post-TKA can guide clinical management.

Purpose of the Study:

  • To characterize sleep patterns in patients undergoing primary total knee arthroplasty (TKA).
  • To compare subjective and objective sleep quality metrics.
  • To assess the association of sleep quality with pain and opioid consumption.

Main Methods:

  • Prospective monitoring of 93 TKA patients using the Pittsburgh Sleep Quality Index (PSQI) and wearable devices.
  • Sleep data collected from two weeks preoperatively to six weeks postoperatively.
  • Mixed-effects linear regression models used to analyze changes in sleep quality and associations with clinical variables.

Main Results:

  • Subjectively, worst sleep quality (highest PSQI scores) occurred between postoperative weeks two and four.
  • Objectively, sleep quality (wearable device data) was poorest in the first postoperative week, improving by week six.
  • A significant positive correlation was found between perceived sleep quality (PSQI) and pain scores (VAS).
  • No significant differences in sleep outcomes or opioid consumption were observed between patients with and without a history of sleep disorders.

Conclusions:

  • Sleep patterns in TKA patients vary between subjective perception and objective measurement.
  • Pain is a significant factor associated with worse perceived sleep quality after TKA.
  • A history of sleep disorders does not appear to negatively impact sleep patterns or outcomes following TKA.