Photo Credit: Katarzyna Bialasiewicz
The following is a summary of “Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty: a prospective, double-blind, pilot, randomised controlled trial,” published in the March 2024 issue of Psychiatry by Yang al.
Postoperative sleep disturbance (PSD) is a common and serious complication associated with poorer recovery after surgery.
Researchers conducted a prospective study examining if transcranial direct current stimulation (tDCS) could improve sleep quality in elderly patients after major lower limb arthroplasty.
They conducted a double-blind, pilot, randomized, sham-controlled trial involving patients aged 65 and above undergoing primary arthroplasty in the lower limb. Participants were randomly allocated to receive either active transcranial direct current stimulation (a-tDCS) or sham transcranial direct current stimulation (s-tDCS). The main focus was on the objective sleep metrics recorded on the first and second nights (N1 and N2).
The results showed that 116 inpatients were assessed, 92 were enrolled, 47 received a-tDCS, and 45 received s-tDCS. tDCS improved PSD by modifying sleep measures in both groups: increasing REM sleep time on N1 (a-tDCS: 64.5 min vs. s-tDCS: 19.0 min, F=20.10, P<0.001) and N2 (a-tDCS: 75.0 min vs. s-tDCS: 30.0 min, F=12.55, P<0.001); total sleep time on N1 (a-tDCS: 506.0 min vs. s-tDCS: 392.0 min, F=14.13, P<0.001) and N2 (a-tDCS: 488.5 min vs. s-tDCS: 346.0 min, F=7.36, P=0.007); deep sleep time on N1 (a-tDCS: 130.0 min vs. s-tDCS: 42.5 min, F=24.4, P<0.001) and N2 (a-tDCS: 103.5 min vs. s-tDCS: 57.5 min, F=8.4, P=0.004); and the percentages of light sleep and REM sleep on N1 and N2 (P<0.05 for each). Postoperative depression and anxiety scores didn’t differ between groups, and no adverse events were reported.
Investigators concluded that while a single tDCS session showed promise for short-term sleep improvement in elderly lower limb arthroplasty patients, the benefit was not sustained.
Source: gpsych.bmj.com/content/37/2/e101173
