Late postoperative nocturnal episodic hypoxaemia and associated sleep pattern

• Published in: British journal of anaesthesia : BJA Vol. 72; no. 2; pp. 145 - 150
• Main Authors: ROSENBERG, J., WILDSCHIØDTZ, G., PEDERSEN, M.H., VON JESSEN, F., KEHLET, H.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.02.1994; Oxford University Press
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Biological and medical sciences; electrocardiography; electromyography; Female; Humans; Hypoxaemia; Hypoxia - physiopathology; Male; Medical sciences; Middle Aged; Monitoring, Physiologic; Monitoring: electroencephalography; Monitoring: electroencephalography, electromyography, electrocardiography; Periodicity; Postoperative Complications - physiopathology; Sleep; Sleep - physiology; Sleep Wake Disorders - physiopathology; Sleep, REM - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Monitoring: electroencephalography, electromyography, electrocardiography; Hypoxaemia; Sleep; Human; Postoperative; Electrodiagnosis; Oxygen; Hypoxemia; Pathogenesis; Surgery; Electrocardiography; Electroencephalography; Electromyography; Rapid eye movement sleep; Abdomen
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/72.2.145

Ten patients undergoing major abdominal surgery under general anaesthesia were monitored with a pulse oximeter, electroencephalogram, electromyogram, electrocardiogram and eye and hand movement sensors two nights before and three nights after surgery. Episodic hypoxaemic events were increased significantly after surgery (P<0.05). Rapid eye movement (REM) sleep decreased significantly on the first night after operation (P < 0.05). Seven patients had increased amounts of REM sleep (rebound) on the second, third or both nights after operation compared with the preoperative night. Slow wave sleep was depressed significantly on the first two nights after operation (P < 0.05). REM sleep-associated hypoxaemic episodes for individual patients increased about three-fold on the second and third nights after operation compared with the night before operation (P < 0.05). We conclude that postoperative sleep pattern is disturbed severely with early depression of REM and slow wave sleep and with rebound of REM sleep on the second and third nights. Postoperative rebound of REM sleep may contribute to the development of sleep disordered breathing and nocturnal episodic hypoxaemia.