背　景睡眠是人類的重要修復功能，然而接受心臟外科手術的病人中，超過50%的患者在住院
期中或出院後都經歷睡眠紊亂。目　的為了瞭解心臟手術病人睡眠型態的恢復狀況並尋找可行的處置，透過本系統性文獻回顧，分析探討心臟手術病患術後睡眠型態與其相關因素。方　法以PubMed、MEDLINE、CINAHL（Cumulative Index to Nursing and Allied
HealthLiterature）、Current Contents與CEPS（Chinese Electronic Periodicals Service）為資料庫，收集1966至2011年有關心臟手術病人術後睡眠型態之觀察性研究。收錄使用多頻道睡眠生理腦波儀、活動紀錄器、或睡眠量表等工具測量睡眠的研究。等同類型的研究
結果則依樣本數計算各睡眠指標之平均。結　果收錄開心手術後病人睡眠的研究中，探討睡眠型態者計有8篇，探討影響睡眠紊亂相關因素的研究計有9篇。結果發現，嚴重的睡眠紊亂包括低睡眠效率與睡眠中斷，通常發生於開刀後的第一週。病人需耗時兩個月才能恢復至術前的睡眠品質。雖然睡眠品質會日漸改善，但睡眠紊亂仍長達六個月。在住院期間，疼痛、呼吸困難、夜尿、及心臟功能等生理性因素，與噪音、光線、及醫療處置等環境因素，與病人睡眠紊亂有關。除了生理因素外，焦慮、憂鬱等心理性因素影響出院後1－6個月的睡眠；年齡與性別等個人因素則影響整個恢復期的睡眠。結論與建議開心手術病人的恢復過程一直持續有睡眠紊亂問題。個人、生理、心理與環境因素和睡眠紊亂有相關。建議在病人住院期間與恢復初期，處理病人的主要症狀並改善睡眠環境，於恢復期則提供心理健康的照護，可能可改善開心手術後病人的睡眠品質。

Background: Sleep is a vital and restorative human function.However, it has been reported that up to 50% of heart surgery patients experience sleep disturbance during hospitalization and after discharge.Purpose: This study describes sleep patterns in adults over the recovery course after heart surgery and works to identify potential interventions. Researchers analyzed and synthesized studies of sleep patterns and sleep-related factors in heart surgery patients.Methods: Observational studies describing sleep through the course of recovery from heart surgery were searched from databases of PubMed, MEDLINE, Cumulative Index to Nursing
and Allied Health Literature, Current Contents, and Chinese Electronic Periodicals Service from 1966 to 2011. Only studies that used polysomnography, actigraphy, or self-report sleep questionnaires to measure sleep were recruited in this review.Results of sleep patterns and sleep quality were pooled from homogeneity studies.Results: Eight studies that investigated sleep patterns in heart surgery patient and nine studies that examined factors associated with sleep disturbances in this patient group were analyzed and synthesized. Serious problems including low sleep efficiency and difficulty in maintaining sleep often happened
during the first postoperative week. It took 2 months for sleep to recover to preoperational levels. Although sleep quality improved over time, sleep disturbances still persisted through 6 months of recovery. Physical factors, including pain,dyspnea, nocturia, and cardiac function, and environmental factors, including noise, light, and procedures on patients,were associated with sleep disturbances during hospitalization.
Psychological factors, including anxiety and depression,affected sleep during the first Y6 months after discharge.Individual factors of age and gender affected sleep through the entire recovery course.
Conclusions/Implication for Practice: Sleep disturbancespersist over the course of recovery in heart surgery patients,and sleep disturbance is associated with individual, physiological psychological, and environmental factors. Findings suggest that management of major symptoms and control of the patient’s sleeping environment during hospitalization and at early recovery stage as well as mental healthcare after
discharge may improve sleep quality and recovery in heart surgery patients.