Sleep Well and Recover Faster with Less Pain—A Narrative Review on Sleep in the Perioperative Period

Abstract

Sleep disturbance, pain, and having a surgical procedure of some kind are all very likely to occur during the average lifespan. Postoperative pain continues to be a prevalent problem and growing evidence supports the association between pain and sleep disturbances. The bidirectional nature of sleep and pain is widely acknowledged. A decline in sleep quality adds a risk for the onset of pain and also exacerbates existing pain. The risk factors for developing insomnia and experiencing severe pain after surgery are quite similar. The main aim of this narrative review is to discuss why it is important to be aware of sleep disturbances both before and after surgery, to know how sleep disturbances should be assessed and monitored, and to understand how better sleep can be supported by both pharmacological and non-pharmacological interventions.

The effects of morning/afternoon surgeries on the early postoperative sleep quality of patients undergoing general anesthesia

“…The results of this study showed that the overall quality of sleep, total sleep duration, and early awakening of the two groups of patients on the first night after surgery were significantly lower than those before surgery. These results concur studies showing prolonged sleep induction, shortened sleep duration, increased number of awakenings, and fragmented sleep after surgery [ 11 , 12 ]. Secretion of MT influences circadian rhythm and is closely related to the sleep rhythm.…”

“…Functioning during the day 0 (0,0) 0 (0,0) 0 (0,1) 1 (0,1) bc Sleepiness during the day 0 (0,0) 0 (0,0) 0 (0,0) 0 (0,0) significantly lower than those before surgery. These results concur studies showing prolonged sleep induction, shortened sleep duration, increased number of awakenings, and fragmented sleep after surgery [11,12]. Secretion of MT influences circadian rhythm and is closely related to the sleep rhythm.…”

Roles of Exosomes and Exosomal MicroRNAs in Postoperative Sleep Disturbance

“…Specifically, administration of zolpidem one night before and on the first night after surgery improves sleep quality and fatigue. 3 , 26 …”

“…Specifically, administration of zolpidem one night before and on the first night after surgery improves sleep quality and fatigue. 3,26 Sleep disturbances in AD patients are characterised by increased duration of awakenings, loss of SWS and REM sleep, and excessive daytime napping. AD patients spend a significant proportion of their day asleep, although this almost completely comprises stages 1 and 2 sleep, which barely compensates for night-time absences of SWS and REM sleep.…”

“…Postoperative sleep disturbance (PSD) is a common complication after a major surgery, 1 , 2 with patients often presenting with reduced sleep quality and duration, early awakening, frequent nightmares, sleep terrors, and sleep-related breathing disorders. 3 Polysomnography studies on patients with sleep disorders have suggested occurrence of sleep fragmentation and deprivation as well as decrease in rapid eye movement (REM) and slow-wave sleep (SWS) after surgery. 4 Additionally, PSD seriously affects the quality of life and increases the difficulty and burden of nursing care.…”