Factors associated with sleep quality in patients undergoing cardiac surgery: A longitudinal study

Background: Poor sleep quality is associated with multiple factors in cardiac surgery patients. Aim: To examine the trajectory of sleep quality and its associated factors over 3 months in Taiwanese patients undergoing cardiac surgery. Study Design: A longitudinal study. This study enrolled 95 patients undergoing cardiac surgery in northern Taiwan. Sleep quality was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale before surgery, at discharge, and at 1 month and 3 months postsurgery. Results: The majority of participants reported poor sleep quality before cardiac surgery (76.8%) and at discharge (81.6%), and they showed significant improvements in sleep quality at 1 month (B = −0.93, p =.023) and 3 months postsurgery (B = −1.50, p <.001). Significant daytime sleepiness was reported by 25.3% of patients before cardiac surgery, and this proportion significantly decreased at 3 months postsurgery (B = −2.59, p <.001). The significant predictors of sleep quality in cardiac surgery patients were symptom distress, sleep medications, occupation, left ventricular ejection fraction, ACE-I drugs and potassium ions, which explained 53.7% of the total variance in sleep quality. Having a nap habit was an independent predictor of daytime sleepiness in cardiac surgery patients, which could explain 3.7% of the total variation. Conclusion: Poor sleep quality was common in patients undergoing cardiac surgery and was associated with multiple factors, including symptom distress, cardiac function, medications, and psychosocial and environmental factors. Relevance to Clinical Practice: Poor sleep quality was observed in cardiac surgical patients before surgery and at discharge postsurgery. Patient education on symptom management, medication adherence and sleep hygiene are suggested to improve sleep quality in patients undergoing cardiac surgery.