From the Guidelines
Sleep difficulties are a common issue after general anesthesia, with patients often feeling sleepy for a day and potentially experiencing disrupted sleep patterns. According to the clinical practice guideline 1, after general anesthesia, patients may feel sleepy for a day, indicating that sleep difficulties can occur in the short term. The guideline also mentions that patients will receive medication for pain, which can further affect sleep quality.
Some common symptoms that may contribute to sleep difficulties after general anesthesia include:
- A sore throat lasting 1-2 days
- Hoarse voice
- Coughing or spitting up small amount of blood for 1-3 days These symptoms, as noted in the study 1, can cause discomfort and potentially disrupt sleep patterns.
In terms of managing sleep difficulties after general anesthesia, non-pharmacological approaches are recommended first, such as maintaining a regular sleep schedule, avoiding caffeine and alcohol before bedtime, and creating a comfortable sleep environment. If sleep problems persist, short-term use of melatonin may be considered, although this is not explicitly mentioned in the provided study 1. The sleep disturbances that occur after general anesthesia are likely due to the alteration of normal sleep architecture and circadian rhythms by anesthetics, as well as post-surgical pain and the stress response to surgery.
As patients recover from surgery and the effects of anesthesia clear from their system, most return to their normal sleep patterns. However, the study 1 does not provide detailed information on the long-term effects of general anesthesia on sleep or specific strategies for managing sleep difficulties beyond the initial recovery period.
From the Research
Sleep Difficulties After General Anesthesia
- General anesthesia can change the postoperative sleep structure, especially in elderly patients after major surgery, and results in a high incidence rate of sleep disturbances 2.
- Sleep disturbances after general anesthesia can produce harmful effects on postoperative patients, leading to a higher risk of delirium, more cardiovascular events, and poorer recovery 2.
- The incidence of dreaming during anesthesia is higher in patients who are interviewed immediately after anesthesia (approximately 22%) than in those who are interviewed later (approximately 6%) 3.
- Commonly used anesthetic agents like propofol, sevoflurane, and ketamine can affect consciousness, pain levels, and autonomic responses, and may influence stages of sleep and circadian rhythms 4.
- Modifying anesthetic regimes depending on the patient's sleep history and risk factors can maximize sleep health and postoperative patient outcomes 4.
- General anesthesia and sleep have commonalities, such as unconsciousness, immobility, non-responsiveness to external stimuli, and lack of memory upon returning to consciousness, but are not the same phenomena 5.
- General anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery 6.
Factors Influencing Sleep Disturbances
- Risk factors associated with postoperative sleep disturbances include age, type of surgery, and anesthetic agents used 2.
- Non-pharmacological treatments such as attention to environmental and psychological factors, and application of electroacupuncture (EA) technology may be helpful in preventing and improving postoperative sleep disturbances 2.
- Pharmacological treatments, including multimodal pain therapy with non-opioid analgesics, can reduce dependence, improve sleep quality, and lower adverse effects 4.
- Effective pain management is a significant component in addressing sleep quality, and opioids can disrupt sleep architecture by reducing REM and SWS, increasing awakening frequency, and potentially causing respiratory depression 4.