Document Type

Article

Publication Date

4-21-2026

Comments

This article is the author’s final published version in npj Digital Medicine, Volume 9, Issue 1, 2026, Article number 479.

The published version is available at https://doi.org/10.1038/s41746-026-02639-w. Copyright © The Author(s) 2026.

 

Abstract

Postoperative clinical care is prone to circadian desynchronization that may influence health outcomes. In an exploratory, feasibility-oriented and signal-exploration effort, we collected 1.8 million data points using 11 remote sensors during preoperative, in-hospital and post-discharge settings in 13 elective cardiac surgery patients (5.2% enrolled from 252 screened). We found that room traffic continued during nighttime with ≥1 visit/h. Sound levels exceeded the recommended 45 dBA threshold (51.9 ± 3.3 vs. 48.3 ± 4.2 dBA during nighttime). Brightness dropped at night (89.9 ± 87.7 to 3.7 ± 9.8 lux), but bright light exposures occurred. Ambient room temperature lacked sleep-inducing diurnal variability. Behavioral-physiological rhythms were disrupted and phase-shifted during hospitalization. Time awake during night hours increased from 10.7 ± 7.9% preoperatively to 34.8 ± 29.1% in-hospital. Cognitive function scores decreased (26.8 ± 2.8 points preoperatively to 24.7 ± 3.9 points in-hospital) with 31% of patients developing transient mild impairment. These data will inform the design of a controlled trial seeking to modify circadian/diurnal disruptors to enhance patient outcomes. Clinicaltrials.gov NCT05828680, November 21, 2022.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Additional Files
Supplementary Materials.pdf (4549 kB)

Language

English

PubMed ID

42014445

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