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Shoulder Journal Club:如何应对肩袖损伤相关的睡不着觉?

已有 1661 次阅读 2015-12-8 07:29 |个人分类:江苏肩关节爱好者微信群|系统分类:论文交流| 江苏省, 肩关节疼痛, 肩袖损伤, 睡眠障碍, 关节外科

2015128日周二高绪仁膝肩髋关节医疗团队在《江苏肩关节爱好者微信群》中要和我们409位肩关节爱好者分享的一篇文章是美国托马斯杰斐逊大学Rothman骨科研究所Luke Austin20156月的The American Journal of Sports Medicine杂志上发表的一篇文章《Sleepdisturbance associated with rotator cuff tear: correction with arthroscopicrotator cuff repair.》。

相关内容将在《江苏肩关节爱好者微信群》中今晚解读。敬请期待!敬请参与讨论!

2015 Jun;43(6):1455-9. doi: 10.1177/0363546515572769. Epub 2015 Mar 16.

Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair.

Abstract
BACKGROUND:

Sleep disturbance is a common complaint of patients with a rotator cuff tear. Inadequate and restless sleep, along with pain, is often a driving symptom for patients to proceed with rotator cuff repair. To date, no studies have examined sleep disturbance in patients undergoing rotator cuff repair, and there is no evidence that surgery improves sleep disturbance.

HYPOTHESIS:

Sleep disturbance is prevalent in patients with a symptomatic rotator cuff tear, and sleep disturbance improves after arthroscopicrotator cuff repair.

STUDY DESIGN:

Case series; Level of evidence, 4.

METHODS:

A total of 56 patients undergoing arthroscopic rotator cuff repair for full-thickness tears were enrolled in a prospective study. Patients were surveyed preoperatively and postoperatively at intervals of 2, 6, 12, 18, and 24 weeks. Patient outcomes were scored using the Pittsburgh SleepQuality Index (PSQI), Simple Shoulder Test (SST), visual analog scale for pain (VAS), and single assessment numeric evaluation (SANE). Demographic and surgical factors were also collected for analysis.

RESULTS:

Preoperative PSQI scores indicative of sleep disturbance were reported in 89% of patients. After surgery, a statistically significant improvement in PSQI was achieved at 3 months (P = .0012; 91% follow-up) and continued through 6 months (P = .0179; 93% follow-up). Six months after surgery, only 38% of patients continued to have sleep disturbance. Multivariable linear regression of all surgical and demographic factors versus PSQI was performed and demonstrated that preoperative and prolonged postoperative narcotic use negatively affected sleep.

CONCLUSION:

Sleep disturbance is common in patients undergoing rotator cuff repair. After surgery, sleep disturbance improves to levels comparable with those of the general public. Preoperative and prolonged postoperative use of narcotic pain medication negatively affects sleep.




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