The effect of rotator cuff repair on sleep quality: Influencing factors and the impact of narcotic medication on postoperative sleep patterns: A systematic review and meta-analysis

Background: Impaired sleep quality often drives patients with rotator cuff tears (RCT) to seek surgical intervention. This meta-analysis reviews the impact of arthroscopic rotator cuff repair (ARCR) on sleep quality beyond six months and identifies influencing factors, primarily narcotics, on sleep quality. Methods: The search spanned PubMed, Google Scholar, Embase, and the Cochrane Central Register, targeting articles evaluating rotator cuff injury and sleep quality. Information gathered included study features, bias risk assessment, evaluation of sleep quality using sleep-specific patient-reported outcomes, and the effects of opiates on sleep outcomes. Results: Ten studies, including 445 patients who underwent ARCR were included. The preoperative mean Pittsburgh Sleep Quality Index (PSQI) varied from 6.6 to 15. Eight studies presented a mean PSQI score of 3.6–7.1 at 6 months postoperatively; two studies reported mean score of 4.2 and 5.4 at 12 months. Both were found to be statistically significant by this meta-analysis compared to preoperative scores. Three studies found narcotic use, RCT size, alcohol consumption, diabetes, and hypertension to negatively affect PSQI scores. Discussion: Arthroscopic rotator cuff repair significantly improves sleep quality at 6 and 12 months following surgery. Perioperative narcotic use, RCT size, alcohol consumption, diabetes, and hypertension may negatively impact sleep quality.