Sleep patterns in women after coronary artery bypass surgery.

Sleep patterns were examined over a 6-month time period after coronary artery bypass graft surgery (CABG) using a wrist-worn actigraph and the Sleep-Rest subscale of the Sickness Impact Profile. The sample included 22 women during the first postoperative week (T1), and 13 of these women during the first posthospitalization week (T2) and the sixth (T3) and twenty-fourth postoperative weeks (T4). Nighttime sleep became less fragmented and, over time, total sleep became more consolidated during nighttime hours, as shown by significant decreases in day, evening, and total sleep and increases in the percentage of total sleep occurring at night during T1. There were also increases in nighttime sleep and percentages of total sleep and the mean sleep interval and decreases in day sleep and evening sleep and nighttime awakenings during T1 through T4. Decreases in the Sleep-Rest subscale indicated perceived improvement in sleep consistent with changes in objective sleep measures over 6 months. These data can be used to help women anticipate changes in sleep patterns over the course of recovery. They suggest the importance of interventions to improve sleep during hospitalization and posthospitalization recovery.

Women's patterns of activity over 6 months after coronary artery bypass surgery.

OBJECTIVE: To examine the relationships between objectively measured activity patterns over 6 months after coronary artery bypass surgery (CABS) and their relationship to self-reported functional recovery at 6 weeks and 6 months after CABS. DESIGN: Time series, descriptive-correlational, convenience sample. SETTING: Hospital and home environment. PATIENTS: Thirteen women who had undergone CABS. The mean age was 62 years (SD 10.76, range, 43 to 78). The mean preoperative New York Heart Association Functional Classification was 2.08 (SD 1.26, range, 1 to 4). MEASURES: Wrist-worn accelerometers and the Sickness Impact Profile (SIP). INTERVENTION: Women wore the accelerometers for 4 week-long intervals: the first postoperative week (T1), the first week after hospitalization (T2), the sixth postoperative week (T3), and the first week of the sixth postoperative month (T4). The SIP was administered at the end of each week of data collection. RESULTS: Circadian rhythms and linear trends in activity were examined with spectral, cosinor, and least squares regression analyses. Repeated measures ANOVA over T1 through T4 demonstrated statistically significant increases in the strength of the circadian rhythms and means levels of activity over T1 to T4. There were no statistically significant relationships between activity parameters at T1, T3, or T4 and SIP scores at T3 or T4. CONCLUSIONS: This study is the first to report changes in circadian rhythms and levels of objectively measured activity over 6 months after CABS. The findings suggest that women's levels of activity and the strength of the circadian rhythm of activity increase between the early postoperative period and the sixth postoperative month. More research is needed to further explore the trajectory of activity patterns after CABS, their relationships to recovery and to determine the need for and effectiveness of interventions designed to promote recovery through activity patterning.

First postoperative week activity patterns and recovery in women after coronary artery bypass surgery.

The purpose of this study was to examine the relationship between activity-rest patterns and recovery in women during the first week after coronary artery bypass surgery (CABS). Twenty-five women wore wrist actigraphs to measure activity objectively throughout the first postoperative week. The Sickness Impact Profile (SIP) and length of postoperative hospital stay (LOS) were used as measures of recovery. Analysis of the activity data indicated that 21 (84%) of the participants had statistically significant positive linear trends in activity. Spectrum analysis indicated that 18 participants had periods that could be defined as circadian, 1 had a shorter period, and 6 had longer periods. After controlling for the effect of preoperative functional status, the period and linear trend of activity explained 28% of the variance in the SIP score at 1 week and 33% of the variance in length of stay. Positive linear trends in activity and circadian activity periods were related to better functioning and shorter length of stay.