By: 11 February 2015
High pain scores keeps surgery patients awake, extends hospital stay

High pain scores can make it difficult for some patients to get a good night’s rest while recovering in hospital following certain surgical procedures, and this often results in longer hospital stays, according to researchers at Henry Ford Hospital in Detroit.

A recent study by Anya Miller and co-workers from the Department of Otolaryngology–Head and Neck Surgery at Henry Ford has shown that patients who reported poor sleep while in hospital following total hip or knee replacement surgery had higher pain scores.

The researchers sought to identify the amount of sleep disruption that occurs in the postoperative in-patient hospital setting. Patients commonly reported being awoken by noise, lights or hospital staff while in the hospital.

Fifty patients who had undergone total hip or knee replacement surgery were included in the study. These surgeries offer variables that are easier to measure in that the surgery and perioperative interventions are standardised with a pain protocol before and after surgery.

The researchers looked at the patients’ total sleep time, sleep efficiency, pain scores and use of narcotics for pain. A hospital floor that observes a quiet time between 10pm and 6am was chosen for the study. A quiet setting where the doors are closed and lights are dimmed enabled them to better determine the relationship between sleep disruption caused by pain.

The study results revealed that patients have significantly decreased sleep efficiency and wake more frequently compared with the general population. While poor sleep results in higher pain scores, use of better pain control can result in improved sleep efficiency and decreased awakenings. The study also found that improved sleep efficiency could result in decreased length of stay in the hospital after surgery.

“Our results show that increased pain scores result in decreased sleep duration,” said Miller. “So better pain control could potentially improve sleep duration for these patients.

“If we can identify factors that cause disruption in patients’ sleep, such as pain, noise and interruptions in the hospital setting, we can help improve sleep quality and potentially decrease adverse outcomes.”

The results of the study were presented at the 2014 American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS) annual meeting in Orlando.