The Effect of Preoperative Sleep Quality on Postoperative Delirium in Middle-Aged and Elderly Patients: A Clinical Setting

OBJECTIVE: To investigate the impact of preoperative sleep quality on postoperative delirium in adults aged 45-64 years and those aged over 65 years undergoing general anaesthesia. STUDY DESIGN: An observational study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Konya, Turkiye, from August to December 2023. METHODOLOGY: Patients aged 45-64 years and those aged ≥65 years who underwent surgeries lasting more than 2 hours under general anaesthesia were assigned to age groups solely according to their chronological age and were observed during routine clinical care. Preoperatively, the STOP-Bang questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Mini-Mental State Examination (MMSE) were administered. Intraoperative and postoperative parameters were recorded. Postoperatively, the PSQI and QoR-15 were reassessed, and delirium screening was performed daily for 72 hours using the 3D-CAM and ICU-CAM tools. Patients discharged early were followed up by phone. Continuous variables were compared using the independent t-test or Mann-Whitney U test, depending on data distribution, and categorical variables were analysed using the chi-square or Fisher's exact test. A p-value of 5), showed a significant correlation with ICU delirium (p = 0.03). CONCLUSION: Poor preoperative sleep quality in elderly patients is associated with increased risk of postoperative delirium. These findings warrant further study. KEY WORDS: Delirium, General anaesthesia, Sleep quality, Age, Pittsburgh Sleep Quality Index, Postoperative outcomes.