Introduction:
Regular sleep is essential for thinking, memory, the immune system, and growth. Many people have trouble sleeping after surgery or dental work with anesthesia, which is not suitable for recovering. Different events that occur right before surgery may worsen these sleep issues. Some of these factors can be controlled to lessen the severity of sleep difficulties. Making sleep better might help with recovery after surgery.
What Is the Natural Sleep Mechanism Under General Anesthesia?
The natural sleep-wake cycle happens every 24 hours and includes different stages of sleep, like deep sleep and dream sleep. People usually go through three to five cycles each day and night. Anesthesia, which makes to lose consciousness during surgery, is similar to one of these stages called deep sleep.
Anesthesia is controlled by the amount and timing of the drugs given, and it affects parts of the brain that regulate sleep. Anesthetic drugs can activate some parts of the brain that control sleep. These drugs also affect the body's internal clock, which controls when someone feels sleepy or awake, and other things like body temperature and the hormone melatonin.
Anesthesia can disrupt the normal sleep-wake cycle and affect the body's internal clock. It might even change the way genes that control the internal clockwork. This disruption can lead to changes in sleep patterns after surgery. For example, some studies have shown that the hormone melatonin, which helps regulate sleep, might be affected by anesthesia, making people have trouble sleeping for a few nights after surgery.
What Is the Causative Factor for Sleep Disturbance After Anesthesia?
Hospital Environment: If a patient is still in the hospital, they might have trouble falling asleep because the atmosphere is strange and noisy. Heart monitors, IV lines, and medical examinations can sometimes cause discomfort.
Body's Healing Reaction: After surgery, the patient's body responds to surgery by becoming slightly irritated. It is similar to when someone gets harmed, and their body swells a little while it heals. But occasionally, this irritation makes it challenging to go to sleep.
Pain and Discomfort: Pain significantly contributes to people's inability to sleep. When someone is hurt, falling asleep takes longer, they would not sleep well, and they could wake up frequently. Additionally, their body becomes more sensitive to discomfort when they would not get enough sleep.
Medication Effects: The medicines doctors use during and after surgery can sometimes disturb the patient's sleep. In particular, the anesthesia used to manage pain and movement can interfere with sleep for older adults. Their sleep may also be impacted by additional medications they take following surgery.
Feeling Anxious or Stressed: Surgery can be frightening or stressful, which may cause someone to feel stressed or nervous. They might be anxious about their recovery or whether everything went according to plan. This feeling can make it difficult to unwind and get to sleep. Not getting enough sleep might also have an impact on how one feels.
How Is Postoperative Sleep Disturbance Is Prevented and Treated?
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Intense and prolonged surgery affects how well the patient sleeps afterward.
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Less stressful surgeries help with sleep by causing less response from the body.
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Reducing stress during surgery with nerve blocks could also improve sleep.
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Pain and morphine can disturb sleep after surgery.
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Using nerve blocks with local anesthesia might help with pain and improve sleep.
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Some early studies show that certain pain relievers after abdominal surgery can help sleep and reduce the need for opioids.
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Noise, nursing activities, not eating, and room temperature can disrupt sleep after surgery.
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Avoid naps during the day, even if a person is feeling tired.
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Many people in the hospital get drugs to help them sleep, like Benzodiazepines. These drugs can affect the different stages of sleep.
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Newer drugs for sleep might be better, but there is no evidence how they affect sleep after surgery.
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People with sleep apnea could have breathing problems after taking certain drugs.
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Post-surgery sleep problems are essential to study as they could affect how well one recovers.
What Are the Functional Changes That Are Expected in Sleep Disturbances After Surgery?
After surgery, people can experience sleep problems like difficulty falling asleep, sleeping too much, or even suddenly falling asleep during the day. Their sleep structure can change, and they might wake up more often. These sleep problems caused by the anesthesia used in surgery could lead to more issues like feeling tired, anxious, and even depressed. In severe cases, it could even increase the risk of stroke.
A natural hormone called melatonin helps us sleep; surgery and anesthesia can disrupt its production. Melatonin makes one feel sleepy at night. If its levels are messed up after surgery, it can affect sleep and cognitive functions like attention and decision-making.
Sleep is also connected to the immune system and heart health. When the sleep is disturbed, it can affect the immune response, making it more vulnerable to infections. Sleep problems are linked to heart and blood vessel problems, too. Issues like insomnia can increase the risk of heart disease and stroke. The body's internal clock, regulated by genes, can be disturbed by anesthesia, affecting heart and brain health.
What Are the Risk Factors Associated With Sleep Disturbances After Surgery?
Complex Factors: Sleep issues after surgery are influenced by various factors, making the situation complex.
Age Matters: Age can affect sleep, as older people produce less melatonin, a hormone that helps to sleep.
Pre-existing Conditions: If someone had sleep problems before surgery or conditions like sleep apnea, ADHD, or polycystic ovary syndrome, their sleep issues can worsen after surgery.
Type of Surgery: The size and type of surgery matter. Bigger surgeries can disrupt sleep due to hormonal changes and inflammation caused by the body's reaction to surgery.
Pain's Role: Pain after surgery is a significant factor. It can make falling asleep and staying asleep difficult. Interestingly, poor sleep can make pain feel worse.
Emotional Impact: Surgery can be stressful, causing anxiety and fear and disrupting sleep patterns.
Hospital Environment: Environmental factors like noise, lights, and disturbances can also affect sleep quality.
Complex Interplay: All these factors interact, creating a mix that affects sleep after surgery.
Conclusion:
After surgery, especially significant surgeries, sleep issues are common. Factors like age, existing health issues, the type of anesthesia, how intense the surgery was, pain after surgery, and stress from the hospital environment can all lead to sleep issues. These sleep issues may hinder a patient's recovery by raising the chances of confusion, making pain feel worse, causing heart problems, and slowing down healing. There are non-drug and medication-based approaches to help with sleep after surgery. These can improve sleep and overall recovery. More study is still needed to know about the long-term effects of these sleep improvement methods.
