Systematic Review of Sleep Quality Before and After Arthroscopic Rotator Cuff Repair: Are Improvements Experienced and Maintained?

Kyle N Kunze; Kamran Movasagghi; David M Rossi; Evan M Polce; Matthew R Cohn; Aditya V Karhade; Jorge Chahla

doi:10.1177/2325967120969224

Systematic Review of Sleep Quality Before and After Arthroscopic Rotator Cuff Repair: Are Improvements Experienced and Maintained?

Orthop J Sports Med. 2020 Dec 29;8(12):2325967120969224. doi: 10.1177/2325967120969224. eCollection 2020 Dec.

Authors

Kyle N Kunze¹, Kamran Movasagghi², David M Rossi³, Evan M Polce³, Matthew R Cohn³, Aditya V Karhade⁴, Jorge Chahla³

Affiliations

¹ Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.
² Department of Orthopaedic Surgery, University of California, San Francisco-Fresno, Fresno, California, USA.
³ Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
⁴ Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

Abstract

Background: Poor sleep quality is prevalent among patients with rotator cuff tears (RCTs) and negatively influences the potential for healing and quality of life. However, there is a paucity of literature describing the magnitude and timing of changes in sleep quality after arthroscopic rotator cuff repair (RCR).

Purpose: (1) To evaluate the prevalence of poor sleep quality in patients undergoing arthroscopic RCR and (2) to determine the timing and magnitude of changes in sleep quality after RCR.

Study design: Systematic review; Level of evidence, 4.

Methods: PubMed, OVID/Medline, and Cochrane databases were queried in January 2020 for literature investigating the prevalence of poor sleep quality in patients with RCTs or changes in sleep quality after arthroscopic RCR. Data pertaining to study characteristics, risk of bias, sleep quality assessments, and clinical outcomes were extracted. A qualitative analysis of the prevalence of poor sleep quality and changes in sleep quality was performed.

Results: A total of 8 studies (1034 patients) were included. The mean Pittsburgh Sleep Quality Index (PSQI) ranged from 5.2 to 15.0 preoperatively among all studies, while the frequency of patients experiencing poor sleep quality ranged from 40.8% to 89.0% in 4 studies. Four studies reported the mean PSQI at a minimum of 6 months postoperatively, which ranged from 4.2 to 7.1. Four studies did not report the PSQI score or the proportion of patients who experienced poor postoperative sleep quality. One study evaluated the PSQI at 12 months postoperatively, which decreased to 4.2 from 5.8 at 6 months. One study evaluated the PSQI at 24 months postoperatively, which decreased to 5.5 from 6.2 at 6 months.

Conclusion: Patients with RCTs have a high prevalence of poor sleep quality. Consistent improvements in sleep quality are observed in the 6 months after arthroscopic RCR, but there is limited evidence based on the available data to characterize changes in sleep quality beyond this time. More evidence is needed to characterize changes in sleep quality beyond 6 months and how these changes are perceived by this patient population.

Keywords: Pittsburgh Sleep Quality Index; arthroscopic; repair; rotator cuff; sleep.

Publication types

Review