Evaluating the Success of Perioperative Self-Guided Meditation in Reducing Sleep Disturbance After Total Knee Arthroplasty

Authors: Michael J Canfield ¹, Michael S Cremins ², Smitha S Vellanky ², Rebecca Teng ³, Robert M Belniak ²

¹Orthopedic Surgery Department, University of Connecticut, Farmington, CT.

²Connecticut Joint Replacement Institute at Saint Francis Hospital and Medical Center, Hartford, CT.

³Force Therapeutics, New York, NY.

Abstract

Background

‍Disruptions in sleep and pain are frequent complaints following total knee arthroplasty (TKA). Perioperative sleep disturbances may lead to decreased pain tolerance as well as other consequences. The purpose of this study is to evaluate the effectiveness of self-guided meditation for improving sleep quality following TKA.

Methods

‍TKA patients, at a single institution, between August 2019 and March 2020 were exposed to a self-guided meditation video during the perioperative period via an online, digital platform. Patients were given an institutionally designed questionnaire to assess sleep quality in the perioperative period. Knee injury and Osteoarthritis Outcome Score-Joint Replacement form, Veterans RAND 12-item Health Survey, and satisfaction scores were also collected. Results were compared between those who reported utilizing the video and those who did not.

Results

‍A total of 380 patients were evaluated. One hundred eighty-nine patients reported utilizing the video, while 191 did not. No significant differences were found among baseline age, gender, or preoperative outcome variables between groups. Postoperatively, the video group's reported time spent actually sleeping improved an average of 52 minutes more than the nonvideo group (95% confidence interval 49.8-52.8 minutes, P < .001). The video group also showed significantly larger decreases in overall sleep awakenings (P < .001), however not pain-related disturbances (P = .726). No significant differences in patient-reported outcome measures were noted between groups.

Conclusion

Sleep quality is an important component of TKA recovery. These findings provide evidence that nonpharmacologic interventions, such as self-guided meditation, may help improve sleep quality in the perioperative period. Future studies are warranted to further investigate their potential benefits.