How to Improve Your Sleep After Heart Surgery
Martin Reed | May 10, 2018
Sleep disruption is one of the most frequently reported problems associated with recovery from heart surgery. Because poor sleep can prolong your recovery period, researchers set out to investigate how to promote better sleep after heart surgery. Read on to learn about their findings, which were published in 2017.
How heart surgery affects sleep
Sleep is thought to be negatively affected by heart surgery due to a number of factors. These include the hospital environment, pain and anxiety during the recovery period, an imbalanced circadian rhythm, and fatigue. Sleep problems typically include frequent nighttime awakenings, reduced sleep duration, and poor sleep quality.
Treatments to improve sleep, reviewed
Researchers performed a systematic literature review of primary studies that included participants over the age of 18 who presented an altered sleep pattern after heart surgery. Ten studies involving 627 individuals met the requirements of the review.
Promoting sleep: Three main intervention categories
Researchers were only interested in methods for improving sleep that did not involve drugs, and grouped the reviewed studies into three general categories according to the type of intervention. These categories were relaxation techniques, devices or equipment designed to improve sleep and/or minimize sleep disruption, and educational strategies.
Relaxation techniques for improving sleep post-surgery
Three of the 10 studies investigated the effectiveness of relaxation techniques, which included massage, progressive muscle relaxation, and posture and relaxation training. Progressive muscle relaxation was found to be particularly helpful when it came to alleviating pain and anxiety — two factors that have a big influence on sleep.
How effective are relaxation techniques?
Heart surgery patients who received neck, shoulder, and back massages two to three hours before sleep by a physiotherapist for three consecutive nights reported improved sleep quality and reduced levels of fatigue. Posture and relaxation training was found to improve sleep quality and lower sleeping pill consumption. Progressive muscle relaxation therapy significantly improved sleep quality compared with the control group (though this study was determined to be of questionable quality).
Equipment for improving sleep after heart surgery
The review found that earplugs and sleep masks were effective at reducing environmental distractions (such as noise and light) that interfere with sleep. White noise involving nature sounds such as rain and waves was found to promote relaxation, help participants fall asleep faster, and reduce nighttime awakenings.
Videos and guided imagery to improve sleep post-surgery
A guided imagery program that used an mp3 player and headphones was found to improve sleep quality and helped participants fall asleep faster, but these results had no significance after analysis. One study found that postoperative patients who watched and listened to music videos enjoyed significantly better sleep-quality scores compared to a control group, although the authors of the review determined the methodological quality of this study to be poor.
Education techniques to improve post-surgery sleep
The review looked at three educational interventions. One program educated patients on how to manage postoperative symptoms. Although fatigue symptoms improved, no significant improvements were found in sleep quality. Another study involved postoperative patients who received an individualized education to promote relaxation and healthy sleep habits. Participants enjoyed improved sleep quality, sleep duration, and sleep efficiency.
What is the most reliable educational technique to promote sleep?
The final educational intervention study included in the review investigated the implementation of a preoperative course designed to reduce anxiety and improve recovery. Those who took the course had significantly lower scores for pain, depression, and anxiety compared with the control group. This study was also found to have the highest methodological quality out of the three educational interventions.
The verdict on drug-free ways to improve sleep after heart surgery
Every single intervention included in the review benefitted the sleep of patients without the use of sleeping pills. With that being said, many of the studies did not demonstrate rigorous methodological quality: In fact, only half presented moderate quality according to the Jadad scale. However, as the review authors pointed out, it is clear that non-pharmacological interventions have the potential to improve the sleep of heart surgery patients and should, therefore, be encouraged.