Multimodal Sleep Pathway for Shoulder Arthroplasty

Shoulder pain at night is a common symptom of shoulder arthritis and contributes to sleep
disturbances. Many patients also have difficulty sleeping after shoulder surgery due to the
constraints of sling immobilization. While in the hospital, sleep is also disrupted due to
pain, nursing staff, other patients, and bathroom use. While poor sleep may appear trivial,
sleep deprivation in animal models has identified significant adverse effects on bone
metabolism, bone mass, and recovery from post surgical pain.

Recent evidence has shown that non-pharmacological sleep interventions that improve sleep
hygiene and duration can optimize athletic peak performance, fatigue, and recovery.
Furthermore, pharmacological sleep aid use with zolpidem in orthopaedic postoperative
patients has suggested safe administration, improved pain control, reduced pain medication
use, and higher patient satisfaction in the settings of total knee and hip arthroplasty,
rotator cuff repairs, and ACL reconstruction.

The purpose of the study is to investigate the efficacy of sleep medicine in the recovery of
orthopaedic shoulder arthroplasty patients. The investigators hypothesize that a multimodal
sleep pathway including non-pharmacological sleep hygiene interventions and the use of
zolpidem can improve patient sleep, pain control, and subsequent recovery after undergoing
total shoulder arthroplasty.

Inclusion Criteria:

All consenting adults undergoing elective total shoulder replacement

Exclusion Criteria:

- Allergies to zolpidem or refusal to participate in study