Analysis of related factors influencing the sleep quality in the patients with rotator cuff tear after arthroscopic surgery

Background: Recent studies have found a prevalence of sleep disturbance in patients with arthroscopic rotator cuff repair. The purpose of our study was to determine which patient-reported factors correlate with sleep disturbance in patients with arthroscopic rotator cuff repair. Methods: We prospectively evaluated 133 patients who had had arthroscopic rotator cuff repaired for 6 months. We obtained the Pittsburgh Sleep Quality Index (PSQI) scores, the visual analog scale (VAS) pain score, the University of California-Los Angeles Shoulder Rating Scale score (UCLA score), the Hospital Anxiety and Depression Scale (HADS), and patient demographic. According to PSQI scores, participants were divided into a sleep disorder group ( A group, PSQI ≥ 5 ) and a normal sleep group (B group, PSQI < 5). Statistical analysis included the Student t-tests, Mann-Whitney U-test，chi-square tests, and binary logistic regression analysis to determine which patient-reported factors were associated with sleep disturbance. Results: The mean scores on the VAS, UCLA Score, UCLA Flexion, HADS-Anxiety (HADS-A), and HADS-Depression(HADS-D) in group A were 3.54, 26.36, 3.25, 5.43, and 5.93, respectively; while in group B were 1.49, 30.72, 4.50, 2.11, and 1.79, respectively. There was a statistically significant difference for scores on the VAS, UCLA, UCLA Flexion, HADS-A, HADS-D between the 2 groups (P 0.05). HADS-D and UCLA Flexion were independent factors affecting sleep disturbance after arthroscopic rotator cuff repair 6 months (P < 0.05). Conclusions: Our study demonstrated patients with sleep disturbances after arthroscopic shoulder surgery had severe pain, more obvious dysfunction, and more pronounced psychologic abnormalities, and the close relationships of depression, UCLA Flexion scores, and sleep disturbance may indicate that more emphasis on psychotherapy and rehabilitation is required.