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Postoperative sleep disturbances after zolpidem treatment in fast-track hip and knee replacement . STUDY OBJECTIVES Previous studies have demonstrated pronounced reduction of REM sleep on the first nights following major surgery which may influence pain , analgesic use , and recovery . This placebo-controlled , randomized , double-blind study set out to evaluate the effect of zolpidem on sleep architecture in an elderly population undergoing fast-track total hip and knee arthroplasty ( THA/TKA ) with length of stay < 3 days . METHODS Twenty patients ( ≥ 60 years ) undergoing THA or TKA in a standardized setup with spinal anesthesia and multimodal opioid-sparing postoperative analgesia were included . Polysomnography measures were performed for 2 nights , 1 night at home prior to surgery and on the first night after surgery , when the patient received placebo or zolpidem 10 mg. Analgesic use , pain levels , and subjective measures of fatigue and sleep quality were recorded . Analysis of sleep data was performed according to the American Academy of Sleep Medicine manual . RESULTS Objective sleep data did not show a significant difference between groups in any of the sleep stages . However , subjective data on sleep quality and fatigue showed significantly less fatigue and better sleep quality in the zolpidem group ( p < 0.05 ) , and reduced objectively recorded number of arousals ( p = 0.004 ) . Levels of pain and opioid use were similar in the 2 groups . CONCLUSIONS Our objective data did not support the primary hypothesis that one night 's treatment with zolpidem would significantly improve sleep architecture following major surgery , although there was improved feeling of sleep quality and fatigue associated with fewer postoperative arousals . CITATION Krenk L ; Jennum P ; Kehlet H. Postoperative sleep disturbances after zolpidem treatment in fast-track hip and knee replacement .
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Intervention_Pharmacological
zolpidem
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Intervention_Pharmacological
zolpidem
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Intervention_Pharmacological
zolpidem
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Outcome_Physical
reduction of REM sleep
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Outcome_Pain
pain , analgesic use
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Outcome_Physical
recovery .
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Participant_Condition
sleep disturbances
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Participant_Age
elderly
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Participant_Condition
knee arthroplasty
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Participant_Sample-size
Twenty
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Participant_Age
≥ 60 years