An exploratory study of the patients' sleep patterns and inflammatory response following cardiopulmonary bypass (CPB)

Aims and Objectives To describe sleep patterns and inflammatory response postCPB, determine sleep pattern changes and inflammatory response over time and explore relationships between sleep and biomarkers of stress and inflammation. Background Despite the numerous citations of the role of sleep in restoration and health maintenance, a paucity of research exists about this phenomenon in patients undergoing CPB. Specifically, there is no research that has explored correlations between sleep patterns and systemic inflammatory response in adult cardiac surgery patients. Design Exploratory, repeated‐measures, correlational study. Method Subjects were recruited from a Midwestern urban hospital. Of the 25 eligible subjects, 16 males and four females completed the study. Wrist actigraphy was used to measure sleep variables. Salivary cortisol and C‐reactive protein (C‐RP) levels were measured daily. Data were collected during postoperative nights/days 1 through 4 (T1–T4). Results Subjects' sleep onset latency (SOL) median scores (0 minute) were within normal range across time periods, whereas median scores for wake after sleep onset (WASO > 270 minutes), sleep fragmentation index (SFI >51%), total sleep time ( 0·05. Median cortisol levels were within normal range (0·3–0·8 μg/dl) from T1−T4, but the C‐RP level peaked at T2 (median = 2370 pg/ml). Strong correlations were found: (1) between SFI−cortisol (rs = 0·82), C‐RP (rs = 0·65) − WBC (rs = 0·69); (2) between SEI−C‐RP (rs = 0·58); (3) between WASO−WBC (rs = 0·48), WASO and cross‐clamp time (rs = 0·50); and (4) between SOL−age (rs = −0·55) at p