Night-time care routine interaction and sleep disruption in adult cardiac surgery

Jesus M. Casida, Jean E. Davis, Aaron Zalewski, James J. Yang

Research output: Contribution to journalArticlepeer-review


Aims and Objectives: To explore the context and the influence of night-time care routine interactions (NCRIs) on night-time sleep effectiveness (NSE) and daytime sleepiness (DSS) of patients in the cardiac surgery critical-care and progressive-care units of a hospital. Background: There exists a paucity of empirical data regarding the influence of NCRIs on sleep and associated outcomes in hospitalised adult cardiac surgery patients. Methods: An exploratory repeated-measures research design was employed on the data provided by 38 elective cardiac surgery patients (mean age 60.0 ± 15.9 years). NCRI forms were completed by the bedside nurses and patients completed a 9-item Visual Analogue Sleep Scale (100-mm horizontal lines measuring NSE and DSS variables). All data were collected during postoperative nights/days (PON/POD) 1 through 5 and analysed with IBM SPSS software. Results: Patient assessment, medication administration and laboratory/diagnostic procedures were the top three NCRIs reported between midnight and 6:00 a.m. During PON/POD 1 through 5, the respective mean NSE and DSS scores ranged from 52.9 ± 17.2 to 57.8 ± 13.5 and from 27.0 ± 22.6 to 45.6 ± 16.5. Repeated-measures ANOVA showed significant changes in DSS scores (p <.05). NSE and DSS were negatively correlated (r = −.44, p <.05), but changes in NSE scores were not significant (p >.05). Finally, of 8 NCRIs, only 1 (postoperative exercises) was significantly related to sleep variables (r >.40, p <.05). Conclusion and relevance to clinical practice: Frequent NCRIs are a common occurrence in cardiac surgery units of a hospital. Further research is needed to make a definitive conclusion about the impact of NCRIs on sleep/sleep disruptions and daytime sleepiness in adult cardiac surgery. Worldwide, acute and critical-care nurses are well positioned to lead initiatives aimed at improving sleep and clinical outcomes in cardiac surgery.

Original languageEnglish (US)
Pages (from-to)e1377-e1384
JournalJournal of clinical nursing
Issue number7-8
StatePublished - Apr 2018
Externally publishedYes


  • acute care
  • adult nursing
  • cardiovascular
  • care activities
  • critical care
  • sleep disturbance
  • sleep quality
  • surgical nursing

ASJC Scopus subject areas

  • Nursing(all)


Dive into the research topics of 'Night-time care routine interaction and sleep disruption in adult cardiac surgery'. Together they form a unique fingerprint.

Cite this