Sleep quality after shoulder arthroplasty - A systematic review

Area of Science:

• Orthopedic Surgery
• Sleep Medicine
• Patient Outcomes

Background:

• Shoulder arthroplasty is recognized for enhancing pain relief and physical function.
• The impact of shoulder replacement surgery on postoperative sleep quality is not well-established.
• Understanding sleep quality changes is crucial for comprehensive patient recovery assessment.

Purpose of the Study:

• To systematically review and synthesize available literature on sleep quality alterations following shoulder arthroplasty.
• To identify the typical trajectory of sleep quality changes in the postoperative period.
• To highlight gaps in current research regarding sleep outcomes after shoulder replacement.

Main Methods:

• A comprehensive literature search was conducted across major databases (MEDLINE, Embase, Web of Science) up to October 2025.
• Studies reporting postoperative sleep outcomes after primary shoulder arthroplasty were included.
• Due to study heterogeneity, a descriptive synthesis approach was employed for data analysis.

Main Results:

• The review included 18 studies involving 2512 patients, revealing high preoperative sleep disturbance rates (84-97%).
• A modest improvement in sleep quality was observed within 6 weeks, followed by significant gains by 6 months, which were generally sustained.
• Despite overall improvement, 13-16% of patients reported ongoing sleep difficulties, with most studies relying on subjective sleep measures.

Conclusions:

• Shoulder arthroplasty generally leads to substantial improvements in sleep quality between 6 weeks and 6 months post-surgery.
• Sleep quality improvements tend to stabilize after the 6-month mark.
• The current body of evidence is limited by a predominance of subjective sleep assessments and a lack of objective, device-based sleep data.