Sleep during and after cardiothoracic intensive care and psychological health during recovery

Publication Type:
Journal Article
Australian Critical Care, 2017, 30 (2), pp. 109 - 135 (6)
Issue Date:
Full metadata record
Intensive care patients and former ICU patients experience poor sleep quality. Psychological distress and diminished health-related quality of life are common among former ICU patients. Coronary artery bypass graft (CABG) surgery is the main reason for adults being admitted to ICU in Australia but the effect of on-pump vs off-pump surgery on sleep and recovery has not been reported. The aim was to assess self-reported sleep quality of CABG patients during and after ICU, psychological wellbeing, HRQOL during recovery and whether on-pump vs off-pump method of surgery affects sleep and recovery. Patients who underwent CABG surgery completed self-report questionnaires on sleep quality, psychological health and quality of life using validated instruments. Data collection occurred in ICU, on the hospital ward, and two months and six months after hospital discharge. Patients (n=101) were aged (mean±SD) 66.6±11.1 years, 79% male and had a median ICU stay (IQR) of 2 (2-4) days, BMI 27.3±4.3 and on-pump surgery (75%). Poor sleep was reported by 44 (62%) patients at six months and by 12 patients (12%) at all time points. Patients who had off-pump surgery had lower posttraumatic stress symptoms (p=.02) and better physical HRQOL (p=.01). In multivariate analysis, prehospital insomnia (P=.004), and physical (p<.0005) and mental p<.0005) HRQOL were independently associated with sleep quality at six months. There was no association between on-pump vs off-pump CABG surgical techniques and sleep quality at six months. Sleep quality of postoperative CABG patients was poor in ICU, in the hospital ward and up to six months. Poor sleep quality at six months was associated with prehospital insomnia, and physical and mental HRQOL at six months, but not with on-pump vs off-pump surgical techniques.
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