Summary of the Article: Daytime Sleepiness and Postoperative Cognitive Decline
This article discusses a study highlighting a potential link between excessive daytime sleepiness and an increased risk of postoperative neurocognitive disorders (PNDs), particularly in older adults undergoing surgery.
Key Findings:
* Prevalence: Up to 20% of adults experience daytime sleepiness, and it may be a previously overlooked risk factor for PNDs.
* PNDs: These disorders affect up to 40% of older patients after surgery, manifesting as delirium (sudden confusion) or longer-term cognitive issues like memory problems and difficulty concentrating.They can considerably impact quality of life and hospital stay length.
* Study results: A study of 96 patients aged 60+ found that those with moderate to severe daytime sleepiness were more likely to experience greater cognitive decline six weeks after non-cardiac surgery. Specifically, 17.1% of patients experienced PNDs, and those with pre-existing sleepiness showed more significant cognitive decline.
* Importance of Screening: The researchers suggest that asking patients (and their families) about daytime sleepiness coudl be a valuable part of preoperative evaluations.
* Causes of sleepiness: Excessive daytime sleepiness isn’t a normal part of aging and can be caused by poor sleep, sleep disorders (like sleep apnea), medications, or other health conditions.
Recommendations:
* Family/Caregiver Involvement: Families and caregivers should spend time with patients and alert the healthcare team to any new signs of cognitive issues (memory problems, inattention, agitation).
* Supportive Care: Healthcare teams should focus on re-orienting patients,encouraging early mobility,and ensuring adequate nutrition and hydration.
* good Sleep Hygiene: Practicing good sleep habits (regular schedule, sunlight, activity, limiting caffeine/alcohol, comfortable bedroom) can definitely help.
* Medical Evaluation: Persistent daytime sleepiness should be evaluated by a doctor or sleep specialist.
* Future Research: Further studies are needed to confirm the link between daytime sleepiness and PNDs and to explore whether treating sleepiness can reduce the risk of pnds.
Source: American Society of Anesthesiologists.