Sex Differences in Postoperative Sleep Quality and Inflammation

Study Overview
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Brief Summary
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Video-Assisted Thoracoscopic Surgery(VATS) is among the most common and disabling persistent pain and inflammation conditions, with increasing prevalence in the developed world, and affects women to a greater degree than men. And sleep disruption also remains a challenging problem in surgical settings. Postoperative sleep disturbances (POSD) are defined as changes in the sleep structure and quality of patients during the early stages after surgery, which are manifested as significantly shortened rapid eye movement (REM) sleep, prolonged awake time, and sleep fragmentation. Long-term POSD may increase the risk of postoperative delirium or cognitive dysfunction and delay recovery, thereby worsening the patient's physical condition. The aim of the study was to investigate the effect of sex differences on postoperative pain, inflammation and sleep quality among patients who have undergone video-assisted thoracoscopic surgery under general anesthesia.

Official Title
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Sex Differences in Postoperative Sleep Quality and Inflammation in Patients Undergoing Video-Assisted Thoracoscopic Surgery

Conditions
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Sex Differences, Postoperative Sleep Quality, Postoperative Pain, Inflammation Function

Intervention / Treatment
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* Other: Video-Assisted Thoracoscopic Surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-80 years old ASA I-III under general anesthesia Exclusion Criteria: patients with central nervous system and mental diseases; patients with preoperative sleep disturbances; patients with a history of sedative, analgesic, or antidepression drug use; patients with sleep apnea or moderate and severe obstructive sleep apnea-hypopnea syndrome;

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Male Group<br> | Other: Video-Assisted Thoracoscopic Surgery<br>* patients receive Video-Assisted Thoracoscopic Surgery under general anesthesia<br>|
| Female Group<br> | Other: Video-Assisted Thoracoscopic Surgery<br>* patients receive Video-Assisted Thoracoscopic Surgery under general anesthesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sleep quality of one night before surgery | Use Athens insomnia scale to test the sleep quality the first night before surgery | first night before surgery | 
| sleep quality of first night after surgery | Use Athens insomnia scale to test the sleep quality the first night after surgery | first night after surgery | 
| sleep quality of third night after surgery | Use Athens insomnia scale to test the sleep quality the third night after surgery | third night after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| visual analog scale(VAS) score after surgery | evaluate VAS score after surgery | one day before surgery | 
| visual analog scale(VAS) score after surgery | evaluate VAS score after surgery | 3 hours after surgery | 
| visual analog scale(VAS) score after surgery | evaluate VAS score after surgery | 8 pm the first day after surgery | 
| postoperative adverse effect | evaluate postoperative adverse effect 24 hours after surgery | 24 hours after surgery | 
| perioperative inflammation function | evaluate neutrophils | two days before surgery | 
| perioperative inflammation function | evaluate platelet | two days before surgery | 
| perioperative inflammation function | evaluate lymphocyte | two days before surgery | 
| perioperative inflammation function | evaluate neutrophils,platelet,lymphocyte | first days after surgery | 
| perioperative inflammation function | evaluate neutrophils | first days after surgery | 
| perioperative inflammation function | evaluate platelet | first days after surgery | 
| perioperative inflammation function | evaluate lymphocyte | first days after surgery | 
| Postoperative cognition evaluation | Use MMSE Mini-Mental State Examination (MMSE) was also evaluated at Sleep preop 1, Sleep POD 1 and Sleep POD 3.18 Each correct answer is 1 point, and error or unknown is 0 point. The unsuitable one is 9 points, and refusing to answer or incomprehension is 8 points. In the total score, 8 points and 9 points are calculated by 0 points. The highest score is 30 points. The division of dementia or not is related to the degree of education. The dementia is affirmed by the patient who is illiterate and less than 17 points, the primary school is less than 20 points, and more than middle school is less than 24 points. The scores which from 27 to 30 is normal, 21 to 26 of mild, 10 to 20 of moderate, and from 0 to 9 is severe. | one day before surgery | 
| Postoperative cognition evaluation | Use MMSE Mini-Mental State Examination (MMSE) was also evaluated at Sleep preop 1, Sleep POD 1 and Sleep POD 3.18 Each correct answer is 1 point, and error or unknown is 0 point. The unsuitable one is 9 points, and refusing to answer or incomprehension is 8 points. In the total score, 8 points and 9 points are calculated by 0 points. The highest score is 30 points. The division of dementia or not is related to the degree of education. The dementia is affirmed by the patient who is illiterate and less than 17 points, the primary school is less than 20 points, and more than middle school is less than 24 points. The scores which from 27 to 30 is normal, 21 to 26 of mild, 10 to 20 of moderate, and from 0 to 9 is severe. | first day after surgery | 
| Postoperative cognition evaluation | Use MMSE Mini-Mental State Examination (MMSE) was also evaluated at Sleep preop 1, Sleep POD 1 and Sleep POD 3.18 Each correct answer is 1 point, and error or unknown is 0 point. The unsuitable one is 9 points, and refusing to answer or incomprehension is 8 points. In the total score, 8 points and 9 points are calculated by 0 points. The highest score is 30 points. The division of dementia or not is related to the degree of education. The dementia is affirmed by the patient who is illiterate and less than 17 points, the primary school is less than 20 points, and more than middle school is less than 24 points. The scores which from 27 to 30 is normal, 21 to 26 of mild, 10 to 20 of moderate, and from 0 to 9 is severe. | third day after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sex differences, postoperative sleep quality, postoperative pain, inflammation function