Insomnia After Surgery

What Causes Insomnia After Surgery?

Insomnia following surgery can be caused by pain, inflammation, and medication side effects. The noise and bright lights of an in-patient hospital setting can also make sleep challenging for those who require overnight hospital stays.

People who experience insomnia Trusted Source American Academy of Sleep Medicine (AASM) AASM sets standards and promotes excellence in sleep medicine health care, education, and research. View Source have trouble falling asleep and staying asleep. About 10% to 15% Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source of adults have chronic insomnia. However, many others experience short-term bouts of troubled sleep making insomnia one of the most common Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source health complaints in adults.

Short-term insomnia, also known as adjustment insomnia, shares the primary symptoms of chronic insomnia though it is usually brought on Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source by an acute stressor such as a job loss or a medical procedure like surgery. The symptoms of short-term insomnia typically resolve as the stressor fades.

Not everyone experiences the same sleep troubles after a surgical procedure. Sleep disturbances tend to be more common in people admitted to the intensive care unit. And major surgeries tend to cause more significant sleep issues than less invasive procedures. However, many different factors can contribute to trouble sleeping after surgery.

Pain

The most common reason people experience sleep disruptions after surgery is pain. Pain can make it difficult to sleep Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source well and nearly all surgeries Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source cause some level of pain.

Inflammatory Response

The body responds Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source to surgery as it would any other injury. The immune system sets off an inflammatory response to help protect the body and prevent infection.

Major surgeries can sometimes spark a more extensive inflammation Trusted Source National Center for Biotechnology Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source cascade that affects the whole body. This postoperative inflammation may contribute to the sleep disturbances many people experience after an operation.

Medication Side Effects

Some of the medications used during or after an operation can make postoperative sleep more challenging.

General anesthesia allows the surgical team to control pain Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source and ensure a person stays still, calm, and unaware during the operation. Some evidence suggests that people, particularly older adults, are susceptible Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source to sleep disruptions from general anesthesia.

Aside from anesthesia, several other types of medications used after surgery can affect sleep including certain antibiotics and steroids, sedatives, and some respiratory medications. People undergoing surgery who use beta blockers Trusted Source National Center for Biotechnology Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source and those who take opioids Trusted Source National Center for Biotechnology Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source for pain relief following surgery may experience difficulty sleeping as well.

Anxiety

Anxiety about surgical procedures, sometimes called acute procedural anxiety Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source , can lead to sleep disturbances before and after surgery and intensify perceptions of pain.

The increase in pain and disrupted sleep caused by acute procedural anxiety can result in sleep deprivation. Unfortunately, sleep deprivation can exacerbate the pain and anxiety a person may already be experiencing.

Environmental Disruptions

People who need to spend one or more nights in the hospital following surgery often have to contend with a handful of disturbances that make it difficult to fall asleep and stay asleep.

Talking staff, phones and pagers, alerts from medical monitors, and loud equipment such as ventilators are all part of the hospital environment and create significant noise. The sound level at a typical hospital is often louder than the World Health Organization suggests for good sleep.

People staying the night in the hospital are also more likely to lack sun exposure during the day while getting too much light exposure at night. Changes in light exposure can disrupt a person’s circadian rhythm and make it harder to sleep at night.

Depending on a person’s condition, spending the night in the hospital after a surgery may also involve check-ins from nurses or other medical staff. While these interruptions are usually medically necessary, they can make it difficult to sleep well.

How to Get Better Sleep After Surgery

To enhance postoperative sleep, your health care provider may try to address factors causing your insomnia. This can include managing anxiety and pain, reducing environmental disturbances, and treating underlying sleep issues.

• Anxiety management: If you find yourself struggling to cope with acute procedural anxiety in the days or weeks leading up to a scheduled operation, talk with your doctor. They may suggest treatments Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source such as cognitive behavioral therapy, medications, or psychotherapy to help with your symptoms.
• Pain management: Before your procedure, speak to your doctor about the expected recovery period and discuss ways to manage pain in the nights following your surgery.
• Block out environmental disruptions: Improve postoperative sleep by eliminating as much environmental noise and light as possible. Some level of background noise and disruptions can be expected when spending the night in the hospital. However, simple tools such as eye masks, earplugs, and white noise may help enhance sleep quality.
• Treat underlying sleep issues: For people who regularly struggle to get a good night’s sleep, taking time to address a pre-existing sleep issue can help improve sleep after surgery. For example, obstructive sleep apnea (OSA), chronic insomnia, and restless legs syndrome (RLS) are common sleep disorders in people who have been hospitalized.

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