Improving sleep after open heart surgery–Effectiveness of nursing interventions

Abstract

Background and Objective: Cardiac surgical patients experience sleep problems in the early post-operative period and after hospital discharged. Restorative sleep is important to be able to handle the challenges of rehabilitation, but often remains untreated. Pharmacological treatment has been preferred, but studies conclude a longer lasting effect of cognitive behavioural therapy (CBT). Few clinical trials have been conducted on nurse led sleep promoting interventions during hospitalization. The hypothesis of this study is that systematic training and education in sleep, sleep anamneses and sleep hygiene enhances nurses’ awareness on sleep problems, and as a result makes nurses able to propose appropriate interventions to improve patients’ sleep during hospitalization, and after discharged. The aim is to examine the effect on patients’ self-reported sleep quality.

Methods: The study design is a controlled intervention study. Patients in the control group received usual care. Patients in the intervention group received nursing focused on improving sleep by use of sleep-anamneses and sleep hygienic principles. Patients’ sleep-quality was measured preoperatively, and one and two month post-operatively by use of PSQI-questionnaire and sleep diaries.

Results: There was no significant effect of the intervention, though there were several signs that had some effect after two months in terms of global PSQI, total sleep time, sleep efficiency, sleep medication and sleep quality.

Conclusions: Systematic education and training of nurses in sleep, sleep anamneses and sleep hygienic principles has some effect on patients self-reported sleep quality two months after heart surgery.