Analysis of patients' sleep disorder after total knee arthroplasty-A retrospective study.

BACKGROUND: Sleep disorder after total knee arthroplasty (TKA) is complex as it greatly differs from patient to patient. Thus, it can be seen that we should further know the detail in sleep disorders following TKA to find well solutions to achieve satisfactory sleep and better recovery.

METHODS: Between October 2011 and January 2016, 965 patients accepted primary TKA. We reviewed each patient's data. Sleep disorder was evaluated via subjective instruments. The Sleep Questionnaire in the present study is a 12-item instrument that evaluates sleep in terms of three dimensions: sleep quality; disruptive factors; and specific forms. Patients were identified and confirmed as at least 1 kind of sleep disorders according to the Second Edition of the International Classification of Sleep Disorders (ICSD-2). And we compare the clinical characteristics and difference in postoperative recovery of different types of sleep disorders.

RESULTS: Sleep disturbances persisted approximately 2 months postoperatively. 75.9% patients was classified into primary insomnias, while 24.1% was secondary insomnias. There was the largest number of those who were adjustment sleep disorder. Pains, mental elements, and factors intrinsic to the patients were the most significant causes of insomnia of patients. There were significant differences in VAS pain score (P < 0.001*), active ROM (P < 0.001*) and LOS in hospital (P < 0.001*) among varied forms of insomnias.

CONCLUSIONS: Our data revealed that adjustment insomnia ranked first. Specifically, the factors affecting sleep quality postoperatively included pains, mental elements, and factors intrinsic to the patients etc. In addition, we found that patients with difficulty in staying asleep and non-restorative sleep has increased pain scores and LOS in hospital with decreased active ROM in comparison to difficulty in falling asleep and too early awakening. Our data may be of a certain benefit to rational use of medication to improve diverse insomnias and to make patients recover better.