Sleep disturbances from pain are a primary driver for patients with rotator cuff tears to undergo surgery.
In a large sample of prospectively collected data, researchers at Brigham and Women’s Hospital found that sleep patterns returned to normal within two years after surgery in 81% of patients and within six months in 77%. Elizabeth G. Matzkin, MD, chief of Women’s Sports Medicine in the Department of Orthopaedic Surgery, and colleagues detail the findings in the Journal of Shoulder and Elbow Surgery.
Using the Surgical Outcome System database at the Brigham, the researchers identified 387 adults who underwent rotator cuff repair performed by Dr. Matzkin between August 1, 2012, and March 1, 2019. Of those, 326 patients preoperatively answered question 2 of the Simple Shoulder Test (”Does your shoulder allow you to sleep comfortably?”). 291 answered negatively, and 35 reported no sleep disturbances.
Patients Without Preoperative Sleep Disturbances
Postoperative follow-up data were available for 32 of the 35 patients with no preoperative sleep disturbances. 12 (37%) reported postoperative difficulties with sleep, of whom 10 had resolution by six months, and one had resolution by 24 months.
Patients With Preoperative Sleep Disturbances
Of the 291 patients who reported sleep disturbances preoperatively, 250 answered question 2 of the Simple Shoulder Test at the three-month postoperative visit. Those patients formed the final analytic cohort.
52% of the 250 patients were women, and the mean age was 56. The mean duration of symptoms before surgery was 14 months. According to the Cofield system of classifying rotator cuff tear size intraoperatively, 78% of patients had small or medium tears, and 22% had large or massive tears.
202 patients reported their sleep disturbances resolved within two years postoperatively:
- 46% by postoperative month 3
- An additional 31% by month 6
- A further 14% by month 12
- The final 8% by month 24
On multivariable analysis, patients 65 and older were more likely to report resolution of sleep disturbances than younger adults (adjusted HR, 1.50; P=0.0202). No other variable studied was significantly associated with the resolution of sleep disturbances.
Surgeons who relay this information to patients considering rotator cuff repair will help them have appropriate expectations about the timeline for recovery.