AUTHOR=Wang Hongbai , Zhang Liang , Zhang Zhe , Li Yinan , Luo Qipeng , Yuan Su , Yan Fuxia 

TITLE=Perioperative Sleep Disturbances and Postoperative Delirium in Adult Patients: A Systematic Review and Meta-Analysis of Clinical Trials

JOURNAL=Frontiers in Psychiatry

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.570362

DOI=10.3389/fpsyt.2020.570362

ISSN=1664-0640

ABSTRACT=<p><bold>Background:</bold> The aim of this systematic review and meta-analysis of clinical trials was to investigate the effects of perioperative sleep disturbances on postoperative delirium (POD).</p><p><bold>Methods:</bold> Authors searched for studies (until May 12, 2020) reporting POD in patients with sleep disturbances following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><bold>Results:</bold> We identified 29 relevant trials including 55,907 patients. We divided these trials into three groups according to study design: Seven retrospective observational trials, 12 prospective observational trials, and 10 randomized controlled trials. The results demonstrated that perioperative sleep disturbances were significantly associated with POD occurrence in observational groups [retrospective: OR = 0.56, 95% CI: [0.33, 0.93], <italic>I</italic><sup>2</sup> = 91%, <italic>p</italic> for effect = 0.03; prospective: OR = 0.27, 95% CI: [0.20, 0.36], <italic>I</italic><sup>2</sup> = 25%, <italic>p</italic> for effect &lt; 0.001], but not in the randomized controlled trial group [OR = 0.58, 95% CI: [0.34, 1.01], <italic>I</italic><sup>2</sup> = 68%, <italic>p</italic> for effect = 0.05]. Publication bias was assessed using Egger's test. We used a one-by-one literature exclusion method to address high heterogeneity.</p><p><bold>Conclusions:</bold> Perioperative sleep disturbances were potential risk factors for POD in observational trials, but not in randomized controlled trials.</p>