Sleep disturbance after primary total knee arthroplasty

Abstract

INTRODUCTION: Literature reported that patients experienced pronounced change in sleep architecture and quality after major surgery. This pilot study aimed to measure the incidence of sleep disturbance after primary total knee arthroplasty (TKA). MATERIALS AND METHODS: Patients undergoing TKA in our institution between 11 June 2015 and 10 July 2015 were recruited. A questionnaire was used to evaluate patients’ self-reported sleep quality and quantity in hospital before and after TKA. Smart wristbands with wearable technology were worn to determine the sleep quantity and quality if patients agreed. RESULTS: A total of 19 patients (17 female, 2 male) with a mean age of 70.1 (range, 57-81) years were recruited. In all, 73.7% (n=14) reported worsened self-rated sleep quality (Likert score decreased from 3.79 to 2.53, p<0.05), and 57.9% (n=11) had increased sleeping hours after TKA (mean sleeping hours increased from 6.31 to 7.21 hours, p=0.14). Reasons for sleep disturbance included wound pain (n=11) and sleep posture (n=10). Data from wristbands shared similar results as questionnaire with increase in both mean awake time (43.6 to 62 minutes) and the sleeping hours (7.1 to 7.4 hours) after TKA. DISCUSSION AND CONCLUSION: This pilot study showed that 73.7% patients had worsened sleep quality after TKA despite longer sleeping hours. Measures should be considered to minimise sleep disturbance, which potentially affects patient’s compliance in rehabilitation.