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Perioperative Sleep Disturbances: A Prospective Cross-Sectional Study on Risk Factor Analysis and Predictive Model
Qin Liao1, Yang Yang2, Changqin Li2
1Department of Pediatric Surgery Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Perioperative sleep disturbances are common in children undergoing surgery, affecting up to 90%. Caregiver sleep issues are a key predictor, and a new nomogram helps identify high-risk children for early intervention.
Area of Science:
- Pediatric Anesthesiology
- Sleep Medicine
- Surgical Outcomes
Background:
- Perioperative sleep disturbances are increasingly recognized as a significant issue in pediatric surgical patients.
- Understanding the prevalence, risk factors, and developing predictive tools is crucial for optimizing patient care.
Purpose of the Study:
- To determine the prevalence and characteristics of perioperative sleep disturbances in children undergoing elective surgery.
- To identify associated risk factors in children and their caregivers.
- To develop and validate a predictive nomogram for early identification of high-risk patients.
Main Methods:
- Prospective cross-sectional study involving 361 children (3-12 years) undergoing elective surgery.
- Sleep assessed using the Children's Sleep Habits Questionnaire (CSHQ) and caregiver sleep via the Pittsburgh Sleep Quality Index (PSQI).
- LASSO and multivariable logistic regression used to identify risk factors; a nomogram was developed and validated.
Main Results:
- A high prevalence of perioperative sleep disturbances was observed (90.0% using CSHQ cutoff ≥41).
- Key risk factors included preschool age, female sex, higher caregiver education, and caregiver sleep disturbance.
- Caregiver sleep disturbance was the most consistent predictor; the nomogram showed good discrimination and calibration.
Conclusions:
- Perioperative sleep disturbances are highly prevalent in pediatric surgical patients, influenced by child and caregiver factors.
- Caregiver sleep disturbance is a robust predictor, and the validated nomogram aids in preoperative risk stratification.
- Further multicenter validation and establishment of specific CSHQ thresholds are recommended.