A pragmatic evaluation of sleep patterns before gynecologic surgery

The aim of this study was to evaluate preoperative sleep patterns in-patients scheduled for elective endoscopic surgery and to compare sleep characteristics before different types of endoscopic procedures. A prospective survey cohort study (Canadian Task Force classification II-2) was designed to evaluate quantitative and qualitative (score 1-7) sleep parameters. Patients completed sleep-monitoring forms on the baseline (6 weeks before surgery), two nights (night-2), and the night before surgery (night-1). Of a total 119 women, 73 (61%) underwent laparoscopies and 46 (39%) hysteroscopies. Forty-seven (40%) operations involved organ removal and 72 (60%) were reconstructive surgery. The mean overall sleep-quality score on night-1 (3.29±0.15) was higher (worse) than on baseline (2.09±0.10, P<0.0001) and night-2 (2.45±0.11, P<0.001, respectively). Patients reported more difficulty falling asleep on night-1 (2.53±0.15) than on baseline (1.61±0.09, P<0.0001) and night-2 (1.84±0.12, P=0.001, respectively). The mean number of nocturnal awaking events was also highest on night-1 (1.52±0.17) than on baseline (0.69±0.09, P<0.001) and night-2 (0.87±0.09, P<0.05 respectively). Using logistic regression, we found that age, stress level, and time before surgery (baseline, night-2, night-1), were significant predictors of poor sleep. The type of planned surgery did not influence the quality of sleep. Falling asleep on night-1 took longer than on baseline and night-2. There was no difference in the sleep quality measures between the baseline and night-2. Poor sleep quality is common mainly in the night before surgery. The nature and extent of planned surgery do not affect sleep quality variables.