Functional performance of patients submitted to cardiac surgery with different levels of sleep quality: an observational study

TL;DR

Poor sleep quality before heart surgery is linked to worse physical performance and more difficulty with physical therapy during hospitalization.

Contribution

This study shows that sleep quality impacts functional outcomes and physical therapy adherence in cardiac surgery patients.

Findings

Patients with sleep disorders had lower functional performance in tests like 6MWT and SST.

Sleep-disordered patients were more likely to refuse physical therapy due to drowsiness.

Lung function and muscle strength were not significantly different between sleep quality groups.

Abstract

•SD in the preoperative period have a lower functional performance.•Good sleep quality had higher functional performance in functional tests.•Physical therapy care for patients with sleep disorders difficult.

SD in the preoperative period have a lower functional performance.

Good sleep quality had higher functional performance in functional tests.

Physical therapy care for patients with sleep disorders difficult.

To describe pulmonary function, muscle strength and functional performance in the different qualities of sleep and the impact of this on the number of physiotherapeutic assistances.

This is an observational study. In the pre and post operative period, sleep behavior was evaluated using the Pittsburgh questionnaire. Patients were divided into three groups: Good Sleep Quality (GSQ), Poor Sleep Quality (PSQ) and Sleep Disordered (SDB). At this time, other tests were also performed, such as: 6-Minute Walk Test (6MWT), Sit and Stand Test (SST), gait speed test and Timed Up to Go (TUG), Medical Research Council (MRC), maximal inspiratory pressure and maximal expiratory, vital capacity and peak expiratory flow. The functional performance and lung function of each group were compared.

A total of 105 people, undergoing cardiac surgery and admitted to hospital were evaluated, 33 with GSQ, 41 with PSQ and 31 with SD. Patients who were in the SDB group had a lower functional performance than the other groups. 6MWT (meters) in the GSQ was 499 ± 87, versus 487 ± 91 in the PSQ and 430 ± 78 in the SD (p = 0.02). In the SST (seconds) it was 10.4 ± 1.1 in the GQS, 11.1 ± 2.3 in the PSQ and 15.4 ± 2.1 in the SD (p = 0.04). Lung function and muscle strength did not differ between groups. Regarding the refusal to perform physical therapy, the SD group was more incident, the main reason being drowsiness.

Based on the results, we found that sleep quality interferes with functional performance and physical therapy assistance during the hospital stay in patients undergoing cardiac surgery.

Figures