Improve Postoperative Sleep: What Can Be Done?

Introduction

Proper sleep is essential for better health and well-being. It is of great importance, especially after major surgeries, to aid in healing and recovery. However, post-surgery patients have been reported to experience insomnia after the surgery. Research indicates patients recovering from surgery who experience sleep problems are more likely to experience delirium, become more sensitive to pain, have more cardiovascular events, and recover more slowly. Various factors can contribute to this condition. Hence, identification of the causes can help take the necessary steps to help the patients sleep better.

What Causes Disturbed Sleep After Surgery?

After surgery, especially major surgery, patients frequently experience severe sleep disruptions. Patients may experience shorter sleep durations, more awakenings or arousals, and poorer sleep quality. There are several factors that can contribute to disturbed sleep after surgery, including pain, medication, and the body's natural healing process.

• Pain: Pain can be a significant cause of disturbed sleep after surgery. Finding a position that is comfortable might be challenging, and pain may wake one up frequently throughout the night.

• Medication: Some medications used during and after surgery can have side effects that can disrupt sleep. For example, many pain medications can cause drowsiness, but they can also cause insomnia or vivid dreams.

• Healing Process: The body's natural healing process can also disrupt sleep. For example, people may experience an increased need to urinate or have difficulty breathing due to congestion or swelling after surgery. These issues can wake a person up frequently throughout the night.

In addition, people may experience emotional distress after surgery, which can also disrupt sleep. Stress, anxiety, and depression are all common after surgery and can interfere with sleep.

What Are the Factors Affecting Postoperative Sleep Disturbance?

There are several factors that can affect postoperative sleep disturbance, including:

• Pain: Pain can disrupt sleep, especially if it is severe or poorly managed.

• Drugs: Some medications, such as opioids, can cause drowsiness, while others can cause insomnia or other sleep disturbances.

• Noise and Lighting: It might be challenging to fall asleep at the hospital due to the bright lights and bustle.

• Stress: The stress and anxiety associated with surgery and the hospital environment can disrupt sleep.

• Sleep Environment: The hospital bed and unfamiliar environment can make it difficult to get to be comfortable and sleep.

• Physical Discomfort: Post-operative discomforts, such as swelling or difficulty breathing, can also disrupt sleep.

• Sleep Disorders: Some people may have preexisting sleep disorders that are exacerbated by the hospital environment and post-operative pain.

If the patient is experiencing sleep disturbances after surgery, it is important to discuss the concerns with the healthcare team. They may be able to help the patient manage the pain and other symptoms in a way that promotes better sleep.

What Are the Effects of Disturbed Sleep on Post-Operative Recovery?

Disturbed sleep can have a variety of negative effects on post-operative recovery. It can delay wound healing, increase the risk of infection, and increase the risk of complications such as pneumonia. Additionally, it can weaken immunity and increase risks of chronic illnesses like heart disease and diabetes.

Disturbed sleep can also have a negative impact on the patient's mental health, leading to feelings of anxiety, depression, and confusion. It is important for patients to get enough rest and sleep after surgery in order to facilitate a smooth and successful recovery.

What Are the Methods to Get Better Sleep After Surgery?

There are different intervention measures to treat sleep disturbances best promptly. They are listed below:

1. Non-Pharmacological Measures:

Non-pharmacological measures involve all the methods other than medications that are used to treat insomniac states. They include

• Stick to a Regular Sleep Schedule: Try to have a consistent bedtime and wake-up time each day, including on weekends. This can help regulate the body's natural sleep-wake cycle.

• Make the Bedroom a Comfortable Sleep Environment: Keep the room dark, quiet, and cool, and use a comfortable mattress and pillows.

• Food: Avoid caffeine, alcohol, and large meals close to bedtime. These can disrupt sleep.

• Use Relaxation Techniques: Techniques include gradual muscular relaxation and deep breathing, or visualization can help the patient relax and fall asleep.

• Consider Using a White Noise Machine: The soothing sound of white noise can help one relax and fall asleep.

1. Pharmacological Measures:

If the patient is having trouble sleeping despite trying these other methods, they may want to talk to the doctor about using a sleep aid. The doctor may advise over-the-counter or prescription sleep aids. Just be sure to follow the doctor's instructions and use caution when using these medications. Some of the medications that are used to treat insomnia after surgery include

• Zolpidem: Zolpidem acts by potentiating the effect of a chemical (neurotransmitter) in the brain called GABA (gamma-amino-butyric acid). This imparts a calming effect on the brain that helps sleep better. However, it should be noted that Zolpidem is only indicated for the short-term management of insomnia. The immediate-release tablets of Zolpidem are given at a dose of five milligrams immediately before bedtime, at least seven to eight hours before the planned awakening.

• Melatonin: Melatonin is a natural hormone secreted by the pineal gland. Normally, the levels of melatonin start to increase during late evening and at nighttime, which promotes sleep in individuals. Melatonin supplements also elicit a similar action by raising its concentration and thereby inducing sleep. It is therefore recommended for treating insomnia states in post-operative patients without major adverse effects.

• Dexmedetomidine: Dexmedetomidine infusion helps to achieve light sedation during the night, enhances sleep by enhancing stage two and stage one efficiency, and changes the 24-hour sleep cycle by shifting sleep primarily to the night.

Conclusion

Patients frequently experience sleep problems after surgery, can have an adverse effect on how well they recover from the procedure. However, various preoperative and postoperative strategies can be employed to help maximize a patient’s comfort, such as minimizing stress and noise levels, providing distraction techniques, and allowing for adequate rest periods. Additionally, providing education on sleep hygiene and familiarizing patients with the use of sleep aids can be beneficial. With the right approach, postoperative sleep can be greatly improved, resulting in a smoother postoperative recovery.