0837 Short Sleep Before Surgery is Associated with Early Postoperative Functional Status in Older Adults

Abstract Introduction Lack of sleep is highly prevalent in older adults and associated with poorer health outcomes. However, sleep is rarely assessed or incorporated into risk stratification prior to major surgery. Whether preoperative sleep duration is associated with functional recovery across a broad surgical population remains unclear. Methods In our ongoing Alzheimer's Association-funded study, 35 older adults (≥70 years; target of 150) have been recruited one week before their major surgery (general, joint, or vascular surgery) and are followed after surgery. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Functional Activities Questionnaire (FAQ) to assess baseline self-reported sleep duration and functional recovery. Sleep duration was assessed at baseline using self-reported, categorized as < 6 hours, 6–8 hours, and >8 hours. Linear regression models were used to examine the association between baseline sleep duration and outcomes at 1 month after surgery. Models were adjusted for baseline FAQ score, age, sex, and surgical type. Results Baseline sleep duration was not associated with baseline FAQ scores (all p>0.75). In the adjusted model using 6-8 hours as the reference category, short sleep duration (< 6 hours) at baseline was associated with higher (worse) FAQ scores at 1 month, after adjusting for baseline FAQ and covariates (β=5.33, p=0.003). The fully adjusted model explained 77% of the variance in 1-month FAQ scores, with an adjusted R²=0.71 after accounting for model complexity. In contrast, longer sleep duration (>8 hours) was not significantly different from the reference group. At the current sample size, the overall PSQI score and other PSQI components also did not show significant associations with 1-month postoperative FAQ outcomes. Conclusion Short sleep prior to surgery was linked to higher FAQ scores at 1 month, suggesting that preoperative sleep may influence postoperative functional status at 1 month, independent of baseline function. These results could highlight the importance of perioperative sleep assessment. Future analysis with a larger sample, longer follow-ups (3- and 12-month), additional adjustments for preoperative health status, and repeated sleep assessments is warranted to assess the longitudinal relationship between sleep and surgical recovery. Support (if any) Alzheimer's Association Clinician Scientist Fellowship (AACSF-23-1148490, L.G)