Factors associated with postoperative sleep disturbance in patients undergoing thoracoscopic radical resection for lung cancer: a retrospective cohort study.
4 affiliations
- 1Department of Anesthesiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
- 2The Graduate School of Xi'an Medical University, Xi'an, China.
- 3Department of Anesthesiology, Gem Flower Xian Changqing Staff Hospital, Xi'an, China.
- 4Department of Anesthesiology, The 923th Hospital of PLA Joint Logistic Support Force, Nanning, China.
Abstract
Postoperative sleep disturbance (PSD) is common in patients following surgery, resulting in severe cognitive and mood disturbances, and even increase mortality risk. This study aimed to identify factors associated with PSD in patients undergoing thoracoscopic radical resection for lung cancer. We retrospectively identified sixty-two patients who underwent thoracoscopic radical resection of lung cancer at Tangdu Hospital, a tertiary teaching hospital in Xi'an, China, from June 2023 through October 2024. PSD was defined as a Richards-Campbell Sleep Questionnaire (RCSQ) score <60 on postoperative day 2 (POD2). Preoperative sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured using the Numeric Rating Scale (NRS) at rest and during coughing on POD1 and POD2. intraoperative fluid volume, and POD2 cough-induced pain, selected a priori based on clinical relevance and prior evidence. Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with PSD. Of 62 patients (mean age 67.5 years; 45.2% female), 36 (58.1%) met the RCSQ-defined criteria for PSD on POD2. Three factors were independently associated with PSD: preoperative PSQI score [odds ratio (OR) =1.58, 95% confidence interval (CI): 1.19-2.10, P=0.001], intraoperative fluid volume (OR =1.004 per mL, 95% CI: 1.001-1.007, P=0.02), and POD2 cough-induced pain (OR =2.23 per point, 95% CI: 1.36-3.66, P=0.001). The model demonstrated good calibration (Hosmer-Lemeshow P=0.10) and discrimination (Nagelkerke R2=0.652). Preoperative sleep quality, intraoperative fluid volume, and POD2 cough-induced pain were independently associated with PSD in this cohort. These exploratory findings highlight the importance of closer assessment of potentially high-risk patients, but require validation in larger prospective studies before being translated into definitive preventive strategies.
Related
- Effect of adding preoperative serratus anterior plane block to intercostal nerve block with liposomal bupivacaine on postoperative pain in patients undergoing video-assisted thoracoscopic lung resection: study protocol for a prospective randomized controlled trial
- Effects of multiple low-dose intranasal dexmedetomidine administration on postoperative pulmonary complications in elderly patients undergoing thoracoscopic radical resection of lung cancer: a single-center randomized controlled trial
- Intraoperative dexmedetomidine reduces postoperative sleep disturbance in older adults undergoing major abdominal surgery: a single-center, randomized, double-blind, placebo-controlled trial
- The influencing factors of postoperative sleep disturbance in elderly patients undergoing transurethral prostate surgery and the construction and validation of a machine learning prediction model
- Development and validation of a predictive model for delayed emergence from anesthesia in elderly patients undergoing video-assisted thoracoscopic surgery: a retrospective study.
BibTeX
@article{weng2026factors,
title = {{Factors associated with postoperative sleep disturbance in patients undergoing thoracoscopic radical resection for lung cancer: a retrospective cohort study.}},
author = {Yujie Weng and Yazhi Zhao and Boyang Wang and Fei Guo and Changjun Gao and Li Sun},
journal = {Journal of thoracic disease},
year = {2026},
month = sep,
doi = {10.21037/jtd-2026-1591},
url = {https://europepmc.org/article/MED/42996974},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Factors associated with postoperative sleep disturbance in patients undergoing thoracoscopic radical resection for lung cancer: a retrospective cohort study.
AU - Yujie Weng
AU - Yazhi Zhao
AU - Boyang Wang
AU - Fei Guo
AU - Changjun Gao
AU - Li Sun
PY - 2026
DA - 2026/09/28
JO - Journal of thoracic disease
DO - 10.21037/jtd-2026-1591
UR - https://europepmc.org/article/MED/42996974
AB - Postoperative sleep disturbance (PSD) is common in patients following surgery, resulting in severe cognitive and mood disturbances, and even increase mortality risk. This study aimed to identify factors associated with PSD in patients undergoing thoracoscopic radical resection for lung cancer. We retrospectively identified sixty-two patients who underwent thoracoscopic radical resection of lung cancer at Tangdu Hospital, a tertiary teaching hospital in Xi'an, China, from June 2023 through October 2024. PSD was defined as a Richards-Campbell Sleep Questionnaire (RCSQ) score <60 on postoperative day 2 (POD2). Preoperative sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain was measured using the Numeric Rating Scale (NRS) at rest and during coughing on POD1 and POD2. intraoperative fluid volume, and POD2 cough-induced pain, selected a priori based on clinical relevance and prior evidence. Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with PSD. Of 62 patients (mean age 67.5 years; 45.2% female), 36 (58.1%) met the RCSQ-defined criteria for PSD on POD2. Three factors were independently associated with PSD: preoperative PSQI score [odds ratio (OR) =1.58, 95% confidence interval (CI): 1.19-2.10, P=0.001], intraoperative fluid volume (OR =1.004 per mL, 95% CI: 1.001-1.007, P=0.02), and POD2 cough-induced pain (OR =2.23 per point, 95% CI: 1.36-3.66, P=0.001). The model demonstrated good calibration (Hosmer-Lemeshow P=0.10) and discrimination (Nagelkerke R2=0.652). Preoperative sleep quality, intraoperative fluid volume, and POD2 cough-induced pain were independently associated with PSD in this cohort. These exploratory findings highlight the importance of closer assessment of potentially high-risk patients, but require validation in larger prospective studies before being translated into definitive preventive strategies.
SN - 2072-1439
SN - 2077-6624
ER -