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

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.