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Measurement of sleep and quality of life before and after coronary artery bypass grafting: A pilot study
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Sleep Dlsorders UnIt, University HospItal, Uppsala, Sweden.
Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
1997 (English)In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 3, no 4, 239-246 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to: (i) test different instruments that focused on sleep, quality of life and personal adjustment in order to evaluate the usefulness of these instruments in a larger study; and (ii) to describe self perceptions of sleep and life situation by patients who had undergone coronary artery bypass grafting (CABG). A one-group pre-test repeated post-test design was used. Six men aged between 51 and 70 years were interviewed, and 24 h polysomnographic recordings were performed before and after the operation. The interviews indicated disturbed sleep and changes in behaviour and mental state immediately postoperatively. Postoperatively the polysomnographic recordings revealed a significant decrease in mean duration of sleep, mean percentage of stage 3-4 sleep and mean rapid eye movement (REM) sleep. One month after surgery the quality of life was improved, while moderate anxiety and sensation of incisional pain persisted. The measurements used in this pilot study provide valuable information into the understanding of altered sleep, quality of life and personal adjustment following CABG.

Place, publisher, year, edition, pages
Wiley , 1997. Vol. 3, no 4, 239-246 p.
Keyword [en]
Coronary artery bypass surgery, nursing, psychophysiological disorders, quality of life, sleep pattern disturbances
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-28412DOI: 10.1111/j.1440-172X.1997.00051Local ID: 13549OAI: oai:DiVA.org:liu-28412DiVA: diva2:249218
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2010-03-23
In thesis
1. Sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting
Open this publication in new window or tab >>Sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting
1999 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In this thesis sleep, psychological symptoms and quality of life (Qol) in patients undergoing coronary artery bypass grafting (CABG) at the University Hospital in Linköping were evaluated. Interviews and 24-hour polysomnography were performed prior to surgery, immediately after surgery and again at one month, with a six-month-follow-up mailed questionnaire. Habitual sleep was evaluated using the Uppsala Sleep Inventory questionnaire and a diary the recorded mornings. The Spielberger State of Anxiety Scale and the Zung's Self-rating Depression Scale were used to measure anxiety and depression, respectively. Physical functional capacity was assessed according to the New York Heart Association's (NYHA) classes and Qol, with the Nottingham Health Profile instrument (NHP).

A retrospective evaluation of nurse's documentation about sleep was also performed. In addition, the quality and quantity of sleep were assessed before surgery and in the immediate postoperative period in a pilot study, with a one-month follow-up interview. The results indicated disturbed sleep, and changes in behaviour and mental state after surgery due to fragmented sleep, pain and anxiety.

Forty-four patients were examined prior to surgery. The results showed that almost two-fifths experienced too little sleep habitually and 50 % had a combination of at least two sleep problems. Poorer health, higher level of anxiety and increased difficulties maintaining sleep (DMS) were consistent with significantly longer sleep latency, increased fragmented sleep, and reduced stages 3 and 4 and RIM sleep measured by polysomnography. The level of Qol on the NBP was significantly associated with objectively measured sleep.

In the immediate period following CABG there is a changed distribution of sleep, with a reduction of nocturnal sleep duration and an increase in daytime sleep, which had almost returned to preoperative values one month after surgery. Qol was significantly improved six months after surgery compared to before surgery.

It was noted that patients with a more anxiety prone reactivity during six months following CABG had significantly more sleep disturbances, reduced energy and functional physical capacity, and lower quality of life, compared to those without such reactivity. Significantly more sleep disturbances, reduced energy and lower quality of life were more prominent among those with sadness/depression or cognitive/behavioural fatigue as reactions to sleep loss. A higher degree of cognitive/behavioural fatigue and dysphoria reactions were associated with a higher NYHA class.

In conclusion, patients with coronary artery disease have poor quantity and quality of sleep. Increased psychological symptoms in patients with CAD prior to surgery were associated with greater symptoms six months after surgery. Physical functional capacity and quality of life were significantly improved six months after surgery.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 1999. 73 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 584
Keyword
Sleep, polysomnography, coronary disease, surgery, anxiety, psychophysiological disorders, personality
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28419 (URN)13556 (Local ID)91-7219-324-7 (ISBN)13556 (Archive number)13556 (OAI)
Public defence
1999-02-19, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
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Note
1999Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2012-01-24Bibliographically approved

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Edell-Gustafsson, UllaHamrin, Elisabeth

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